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HomeMy WebLinkAboutXR2023-0060 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application Comm'I F_ Residential City of Newport Beach - Building Division o: NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL F-Building F_ Grading F-Drainage i-Elec I-MachF-Plum CuvdCut s CuYdFill Project Address (Not mailing address) f- Flood F_ Fire 7- Liq r Landslide FN/A Floor Suite No 3106 Rr✓er Ave F_ Description of Work Use ConstType s 1 ac �C ',n.i c 11 y-/-1-x l , hz, ©.1 /Vc. f 5 • �� , # Stories # Units (if Res)[ — Valuation ' S- O c" Material/Caa bo / New/Add SFr__Remodel SFs Garage/New/Add OWNER'SNAME Last %Lo54vt First �( Owner's Address Owner's E-mail Address City Ne-vrrd- 15-"Cdl State Zip Telephone[d 2 t(�- $ZIT 2qvil�/- _ APPLICANT'S NAME Lash y %, Z First �S f Applicant's Address Applicant's E-mail Address 1 ` '/ City (� i ;'� State f A Zip Telephone -7 Zqo - n y yp ARCHITECT/DESIGNER'S NAME Last First Lic. No.I Architect/Designer's Address Architect/Designer's E-mail Address City State �— Zip Telephonel— ENGINEER'S NAME Last s First Lic No.s— Engineer's Address Engineer's E-mail Address City State Zip F Telephoner CONTRACTOR'SNAME/COMPANY /)G� �✓� IdL S �j `et� Lic No. (QS ?j5-/Class CZ% /' Contractor's Address Contractor's E-mail Address l L4 Z �- Q / , �C � -� c � fie" 6) P7 L l kn al /. c o "I City ���j� IV, State C� Zip Cr2CcC Tellephone 7jy-67$ �jLg`c SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $