HomeMy WebLinkAboutXR2023-1702 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application o4,�y�"e
j- Comm'I )- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
r-Building r Grading r-Drainage r Elec r Mech r Plum cuvdCut F cuYdFill F
Project Address (Not mailing address) r Flood r Fire r Liq r Landslide rN/A Floor Suite No
6 i
R1w-"t Z)a, CCU N DEt
Description of Work
Use F—Const Type F_
# StoriesF # Units (if Res)F
I
aluation $
Material/Labo a-0,00L)
New/AddSFF Remodel SFF Garage/New/Add—
OWNER'S NAME Last �i 7/g /'v First m,;g* e-o
Owner's Address Owner's E-mail Address
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City Wrooel T)ej r%�c] State CC; Zip q/ t4 ?_G TelephoneF—
APPLICANT'S NAME Last zpm( )oq First VY-roal'v
Applicant's Address Applicant's E-mail Address
�p� E ��rl I9VE �Pf l9
City UI 1,9117 ;C State F54 Zip G� ��C� TelephoneF_
ARCHITECT/DESIGNER'S NAME Last z)n S 11+1 First /4/i Lic No.
Architect/Designer's Address Architect/Designer's E-mail Address
75 2 I -Edih ejr � I/e �l�/I 3�G LI
City H�i1✓) 7`! i�1�i fU� 13PrnGH State C Zip 9;G' %17 Telephone
ENGINEER'S NAME Last First DGV Lic. No. 6 X772
Engineer's Address Engineer's E-mail Address
3)3o £ wl'ilow 54
City tov) 1A�L11 State I - Zip qQ''S5 Telephone
Lic No. 1o6�(q�i8 Class L�f�
CONTRACTOR'S NAME/COMPANY C�
Contractor's Address Contralcttor's E-mail Address
pec, Ve- j,4p 4. (�
City oit2 E State I CH Zip TjD 6�� Telephone ��� �()GJ-5G�-66
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SETBACKS REAR SETBACKS FRONT I G (90 -- t & k PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO Q767 — 04l / PLAN CHECK FEES $