HomeMy WebLinkAboutXC2023-0108 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division o R
(- Comm'I I— Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
FBuilding r Grading F-Drainage i- Elec r Mech i- Plum CuvdCut s CuvdFill s
Project Address (Not mailing address) r Flood i- Fire r Liq r ide t-N/A Floor Suite No
aZ/(21 /4
Description of Work
( b .�d c
5 T t lc
New/Add SFs—
OWNER'S NAME
Owner's Address
I
City r--
APPLICANT'S NAME
Use s ConstType
all
# Units (if Res)s
# Storiess
? CC Valuation $
Remodel SF F— Garage/New/Add F-- I Material/La
Last I GA <lw- First j
Owner's E-mail Address
State I Zip F— Telephones
Last I L- / - lti'( rc -,1 /✓
Applicant's Address
City F3(-((rCGee-z: p'l State F7
ARCHITECT/DESIGNER'S NAME Last I
Architect/Designer's Address
z;7 A l vl, w i,) « Arc l ��
City (- State FEA,
ENGINEER'S NAME Last
�,w
First I
Applicant's E-mail Address
Zip T 6C Telephone 5:2 -771- 5-;?5
First Q j .J Lic. No. F2 )6 1 k'
Architect/Designers E-mail Address
Zip 1 �Zi �6 Telephone ild 2v(�
First
Lic.
Engineer's Address Engineer's E-mail Address
City �— State F_— Zip �— Telephones --
CONTRACTOR'S NAME/COMPANY Lic No. ` le�'2 7y Class
Contractor's Address Contractor's E-mail Address
/y12y A42 itch= G�JG(- /14,,d
City 6 cz ( [-, L vl-;,6( State 77 Zip y, ;;t:C Telephone SC;�-77
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $