HomeMy WebLinkAboutXR2023-1529 - Permit ApplicationPrint Form, -� Workshect for Combo-BuRding.& Solar Permit Application A.0
Wsj`�mm'I esidential City of Newport Beach - Building Division
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Project Address (Not mailing address) F_ Flood Firer Liq F_ Landslide F_N/A Floor Suite No
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Valuation $
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OWNER'S NAME Last �f/ C /' �'i/ 't �CJ First
Owner's Address —�-
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CANT's NAME Last —7 x First
Applicant's Address Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last �/a/j I First p./
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Architect/Designer's Address Architect/Designer's E-mail Address
City State �i I --� �Telephone�—
Last First Lic. No. F—
Engineers Address Engineer's E-mail Address
City State Zip F— TelephoneF
CONTRACTOR'S NAME/COMPANY Lic. No. Class
Contractor's Address Contractor's E-mail Address
city State F Zip F— Telephones®¢
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $