HomeMy WebLinkAboutXR2023-2755 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application o a
IF Comm'I
j Residential City of Newport Beach -Building Division
NOTEPI AN r.HFr:K FPFc M1 iG AT Tinnc 1 oo_. 'T
j�Building r Grading f—Drainage F Elec F- Mech V
� Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing
address) F_ Flood F Fire F Liq j_ Landslide F_N/A Floor Suite No
Description of Work
Use F— Const Type
, ,
$
# StoriesF_ # Units (if Res)-
;?D Lon r/j (S� fjt�s
S ih �/' g
New/Add SF�— ----
Remodel SFr---- Garage/New/Add F—
Valuation $ - e
Material/LaborIC i
OWNER'S NAME Last
TQ� ytn�/r �' � fig First
Owners Address
Owner's E-mail Address
City
State F-- Zip F_ TelephoneF_
APPLICANT'S NAME Last
�\ /�-F� First
Applicant's Address
Applicant's E-mail Address
City
State �— Zip lf� Telephone?/� 2 C
/ J ✓�
ARCHITECT/DESIGNER'S NAME
Last First F_ Lic. No. �—
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
City
State F— Zip F— Telephone —
ENGINEER'S NAME Last
6 baC� First C'� /—� Z
I/I *"�\ Lic No.7 oo J
( /
Engineer's Address
Engineer's E-mail Address
lZd/ . T.s74'h Ave
City /�
State /Q, Zip �f1�Y Telephone 6 �/0 0
00NTRACTOR'S NAME/COMPANY
Lic. No. $6 Class C2�
1
Contractor's Address Contractor's E-mail Address
!%F_ 7111 44- J05r- &/ha S�ons74uc
City /� "� � `
✓G(// l,�
b�, rv�
State %°�— zip Vy �% 70 Telephone i/G 25p
l� / V / / I o
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GPERMIT
SETBACKS REAR
SETBACKS FRONT NO.F�,�t2
SETBACKS LEFT
SETBACKS RIGHTPLAN CHECK NOUSEZONE
DEVELOPMENT N >� . - PLAN CHECK FEES