HomeMy WebLinkAboutXC2023-0060 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division
Comm'I Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Yuilding F_ Grading
f—Drainage F_Elec r"Mech F Plum Cu vd Cuts Cu Yd Fill
Project Address (Not
mailing address) 1- Flood r Fire [_ Liq r Landslide FN/A Floor Suite No
Description of Work
Use ConstType s
$PIS S Air
0� ti0�- I t ,,r,. b1A J.0 <C,-
# Stories # Units (if Res)s
Valuation $
Material/Labor f 0 '�-
i
New/Add SFF—
Remodel 5FF— Garage/New/Add F—
OWNER'S NAME
Last First
Owner's Address
Owner's E-mail Address
City
State �— Zip Telephone
APPLICANT'S NAME
Last y f �G f rq First q
Applicant's Address
Applicant's E-mail Address
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r�`SJ .� .%},ic ctnl �.�,,.`fS � 7/ha•�,�/`�
City t�C�I/ n
State ' Zip Zf,7Z Telephone-IS1 1\0 —1kIb
ARCHITECT/DESIGNER'S NAME
Last First �T Lic. No. �—
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State F_— Zip I Telephone
ENGINEER'S NAME
Last First Lic No.
Engineer's Address
Engineer's E-mail Address
City �Y State Zip Telephones
CONTRACTOR'S NAME/COMPANY
fw^ 5nS Lic No. (,p(, 0[!, - Class FCyr
L
Contractor's Address
Contractor's E-mail Address
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City C�(1 A
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State FEW- Zip ,I 3 Z Telephone ZQ rj. 7(, , 96
SETBACKS REAR
SETBACKS FRONT PERMIT NO. &TanP • -cx,&0
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. J&Uj,7,O +Fp
USE ZONE
DEVELOPMENT NO r?ZVZjj oV(I PLAN CHECK FEES $