HomeMy WebLinkAboutXR2023-0823 - Permit ApplicationPrint Form_ Worksheet for Combo Building & Solar Permit Application uF��
F_ Comm'I r 1Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIMF OF St IaMITTaI
I74uilding F_Grading r-Drainage F_Elec F_Mech Plum CuvdCut CuYdFill F
Project Address (Not mailing address) F_ Flood f Fire j- Liq [_ Landslide f-N/A Floor Suite No
Description of Work
Use F_ ConstType�
as�(��� -- -
x� # Stories #Units (if Res)
-- ----------
--- -----_ --- -- Valuation 5 n ^,ODOT
New/Add SF�— Remodel SF�— Garage/New/Add Material/Labor
-' ---
OWNER'S NAME Last pp
First qYl
Owner's Address Owner's E-mail Address
�O.Xv�11 �lih�eS.catn
J
--
City t' y n
State
N�p� 6 �( Zip Telephone
APPLICANT'S NAME Last L First ��,►� ��
Applicant's Address Applicant's E-mail Address
\) 'P -_ 5 1% 4oa t.� � H e,,VtOM 4LV e,, &VM
City State C,06%- Zip �ODZ� Telephone - - -
ARCHITECT/DESIGNER'S NAME Last First V f�U Lic. No. C_/LLo3%/
Architect/Designees Address Architect/Designer's E-mail Address
tAPPgLAakj&W ,GDWt
I
Ws(pis State Zip - -- - --- -'
City �po 2� Telephone
ENGINEER'S NAME Last First Lic. No.�—
Engineers Address Engineer's E-mail Address
City State F® Zip Telephone[777—
CONTRACTOR'S NAME/COMPANY LJ j fj� Lic. No. b ClassFC
Contractor's Addresses Contractor's E-mail Address
- �Q� G1ll�CJr b7�'Ny Oi! iL•GL7J11
City L) In E-YIA Os, O State I Zip 1a Telephone -� lb-rjZ
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $