HomeMy WebLinkAboutXR2023-0832 - Permit ApplicationJ__Print Form_ _ j Worksheet for Combo Building & Solar Permit Application
F_ Comm'I F- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
wilding F_ Grading F-Drainage F_Elec
Project Address (Not mailirq
.+l ,f --wC ieY- c
Description of Work
G � �
New/AddSFRemodel
OWNER'S NAME Last I K 5-
\t,o
F_Mech
FPlum
CuYdcutl
CuYdFill l
F_ Flood
r Fire F_ Liq
F_ Landslide
F_N/A Floor
SFI ) r ; �n Garage/New/Add
First
I
Suite No
Use ConstTypeF
# StoriesF— # Units
Owner's Address Owner's E-mail Address
City State .. _� /! - Zip 1/ Telephone �(�in oo
APPLICANT'S NAME Last
Applicant's Address
-DS---_-
City State l CA
First
Applicant's E-mail Address
- - -- - �— -
Zip Telephonel
ARCHITECT/DESIGNER'S NAME Last l �v1C t W � First SUS t9 _
ArchitecUDesigner's Address
City Sc `�Q —1�r State L CW
Lic.No.I SIS3
Architect/Designer's E-mail Address
Zip C�� Telephone ckr_p }3S t^
ENGINEER'S NAME Last First Lic. No.
Engineers Address
City t �� State
adllP• -
Engineer's E-mail Address
Zip -.. Cia o s Telephone cL tR 5 5
CONTRACTOR'S NAME/COMPANY w2Y 2 Lic. No. \p Class 22
Y�l2e — fSiC11�(( i' rarNgty"Ut-t A �n }6
Contractor's Address
Contractor's E-mail Address
City d f V tiQ State �— Zip -q ( 6 ` Telephone C( [( 3
SETBACKS REAR SETBACKS FRONT PERMIT NO. ic\Zz P�Z� Oa3
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. S'G1z)z-_,S _c)-7 i 6
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $