HomeMy WebLinkAboutPV2023-0327 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application off`""°^
r Comm'I F_ Residential City of Newport Beach - Building Division o _
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL ° ^''
rT Building r Grading rDrainage r Elec r Mech r Plum Cu yd cut Cu Yd Fill F
Project Address (Not mailing address) r Flood r Fire (- Liq F- Landslide FN/A Floor Suite No
�ZL' Dfit ph, F �--
Description of Work
Use F—Const Type F
# StoriesF_ # Units (if Res)F_
Valuation$
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�IS1W/� CC*1b,4er- 9/1^ Pi56u;,,4eCf, 17,92 kw pCYM S,zC
New/Add SF�- Remodel SFF Garage/New/Add �—
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Material/Labor `� 0 C OU
OWNER'S NAME Last F p X First P e I e
Owner's Address Owner's E-mail Address
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City F u/ 0 rl f M 1 r State >4 Zip L b J5 Telephone (q. 6 g) Z 17 -111 j
APPLICANT'S NAME Last �CO Z /� �/ S First I x# V ii Cv-
Applicant's Address Applicant's E-mail Address
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City I �q9 q rt `F �j' (� q C State Zip � L S S Telephone r(S 1,4) 16 y- 77 SJ
ARCHITECT/DESIGNER'S NAME Last l— First �— Lic. No. F--
Architect/Designer's Address Architect/Designer's E-mail Address
P/T c/5,, i ev On gin eery' N-
City �- State F— Zip F_ Telephonef—
ENGINEER'S NAME Last q n at 1-9 First E eA e Lic. No. V g j
Engineer's Address Engineer's E-mail Address
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City �— State F— Zip Telephoned
CONTRACTOR'S NAME/COMPANY M, e gdlef SR,{(e'r Sp/w1, Lic No. ,7-S.j3 Class C-y7,
Contractor's Address Contractor's E-mail Address
gU� Ie�neX/{ St r —Te 25a/dlcrso(vr,cern
City q w F' /t,q C g C h State Zip Z e5 / Telephone C 9qv Set Q
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. Fr_ ZOZ 3 - /0(01
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $