HomeMy WebLinkAboutXC2023-0140 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
jy( Comm] r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
I —Building r Grading F-Drainage XElec r Mech r Plum CuvdCut r— CuYdFill
ject Address (Not mail
900 P7,;I>ToL_ S 7
of Work
I j- Flood r Fire r Liq r Landslide rN/A Floor
r
N,FwPDRT RCaCH I
Suite No
I
UseF_ ConstType F_
# Storied— # Units (if Res)[ —
IV $ � CU D 0 c' c
New/Add SF�y�— Remodel SFI— Garage/New/Add �— Material abor�
OWNER'S NAME Last I --7F ;12- � 1ZL y11 G V\, First UJ Gf
Owner's Address Owner's E-mail Address
6�&C-1(f) r/Sr.7 /41W?0 A 'e
City1 -1FV10"?, State CA'V,- Zip C1 rp�,`L Telephone �y9— Y90
/ 0 Z Z
APPLICANT'S NAME Last I Co i` d o Lf C)
Applicant's Address
2 3 o & "4r;r V
City I Qq � I,q State
ARCHITECT/DESIGNER'S NAME Last
First I q 4-d�
Applicant's E-mail Address
Zip ° 9 Telephone ..3l() L/88
First
Lic. No. I--
Architect/Designer's Address Architect/Designer's E-mail Address
City I State �— Zip F_ Telephone F_
ENGINEER'S NAME Last
Engineer's Address
First
Engineer's E-mail Address
Lic.
City State 7— Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY 12 A S Lic No. Fe 7 32?gClass F,_ 9
Contractor's Address � �7 Contractor's E-mail Address
�3�0�✓lire J� fct'YC- SI�S_ Gorvl
City UIJ 'tti(r State CA Zip Telephone A) y88-7 / Q V
SETBACKS REAR SETBACKS FRONT PERMIT NO. xC:707jj-2!�_
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. t foeZ/- OW-7
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $