HomeMy WebLinkAboutXR2023-0290 - Permit ApplicationPant lrorro�J Worksheet for Combo Building & Solar Permi Application 0
Ft—Comm'l F—tResidential City of Newport Beach - Building Division 6100- ON 0
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
FL,Building F_ Grading
F—Drainage f— Elec F_ Mech r— Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) Flood [_ Fire F— Liq F_ Landslide F_N/A Floor Suite No
.4&
Description of Work /V,(� 7/1-it
Use PC - 4/0 Const Type
# StoriesI l # Units (if Res
A-7w�?
► /-Type /2 c)
Valuation $
Material/Labor
New/Add SF[
/zf,}reA/V A 1L_,
emoclel SF
p � Garage/New/Add
_
OWNER'S NAME
Last First
Owner's Address
Owner's E-mail Address
City
zip Telephonel.-, - -- - ------_--_- - -
APPLICANT'S NAME
Last First
Applicant's Address
Applicant's E-mail Address
6,4uv,' A 2 C 71. j () 0
City 2)
State F777i7 Zip F_777`Z_ Telephonel
ARCHITECT/DESIGNER'S NAME t
Last A A,1 e /2- Firs Lic. No. 22 2,
Architect/Designer's Address
Architect/Designer's E-mail Address
_,e V,�
. ....... .
City
- - --------------
State Z10j Telephone
ENGINEER'S NAME
Last F_ First Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State zip Telephone
CONTRACTOR'S NAME/COMPANY Lic. No.7T_1r1_3 Class
Contractor's Address
Contractor's E-mail Address
City
F
State Zip Telephone F
SETBACKS REAR
SETBACKS FRONT PERMIT NO. —0 2f4 0
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. a/l.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $