HomeMy WebLinkAboutPV2023-0233 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
j- Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
,Building rGrading F-Drainage rElec F_Mech
F-Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) r Flood
r Fire r Liq r Landslide F_N/A Floor Suite No
/? 2 2 O r-(, t-w Pr
I I
Description of Work
Use I— ConstType
q Stories # Units (if Res)F
-p / D
1Wt 5 TA/I I /rooF I oy q (GG(/ / V SN5/
le l., / l5
$•4aa,kw Ac
Valuation $
Material/Labor
New/AddSFF_ Remodel SFF-- Garage/New/AddF_
OWNER'S NAME Last ST�e,�G
First ,%)qV tf
Owner's Address
Owner's E-mail Address
/ 72
PAV;sPsfre�G(a 9ma.� co yr
City NC•v/>orf IS3fa �i State
Zip q'2 4 66o Telephone y Z/ � �� 7
APPLICANT'S NAME Last Rodriguez
First Adriana
Applicant's Address
Applicant's E-mail Address
7200 Fenwick Ln
Permitsorange@freedomforever.com
city Westminister State CA
zip 92683 Telephone 562-340-1524
ARCHITECT/DESIGNER'S NAME Last First Lic. No. F
Architect/Designees Address
ArchitecUDesigner's E-mail Address
City State F_
Zip F_ Telephoned
ENGINEER'S NAME Last
First F_ Lic. Nos
Engineer's Address
Engineer's E-mail Address
City State F_
Zip F TelephoneF-
CONTRACTOR'S NAME/COMPANY Freedom Forever
Lic Noj 1029644 Class
Contractor's Address
Contractor's E-mail Address
43445 business park dr
Permitsorange@freedomforever.com
City temecula State CA
Zip F92590 Telephone
SETBACKS FRONT
NO. _f 0Z S `b�
SETBACKS REAR
PERMIT Y G J�
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $