HomeMy WebLinkAboutXR2023-0326 - Permit ApplicationPrint Form IWorlksheet for Combo Building &-Solar Permit Application
r Comm'I f7 Residential City of Newport Beach -Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F-Building F Grading
Project Address (h
Description of Work
r'Drainage F-Elec
r Mech F'-Plum Cu Yd Cut— Cu Yd Fill
_
address) [ Flood F-_' Fire Liq F_ Landslide [N/A Floor
Suite No
9 L44e
New/Add SF�- Remodel SF F_ Garage/New/Add �—
OWNER'S NAME Last
First F7 77
Owner's Address
Owner's E-mail Address
_LI_.�� Rocti.c(ILrpr
city ---
State
- �j.� --- ----
IVw
- -- ZIP 9244,0 Teleohc
Use s ConstType IF,*—
# Stories # Units (if Res)
Valuation $ 71�/�Material/Labor�
--- - — APPLICANT'S ---
NAME Last
- _ (Fcti Cr•rti � FIrSt (,roq�i
Applicant's Address
Applicant's E-mail Address
�6/4 Ptca�rll w 9 cI/IA-O_ _ Mai l.Ca.+..
- -
City r �tl�ir
- - - ----
- State GA Zip 9L8 i, Tele hone - - _.___ P 7rK-„2zt-1433
ARCHITECT/DESIGNER'S NAME
Last First �-
- Lic. No. �_
Architect/Designer's Address
Architect/Designer's E-mail Address
City F-State �— Zip
- — -- ----
- ..-.—._ _ _ Telephone[
—
ENGINEER'S NAME Last
aWYK.
Engineer's Address
3 q&7 PFcrt
City State C
CONTRACTOR'S NAME/COMPANY
Contractors Address
�qU l C pa(�yr, f}rc
City O r�tiu
First Lic No.
Engineer's E-mail Address
b(ftrKe. cov,
Zip 924 z, Telephone y 9 — Z2te ` 713
Ah4-t7. kprw%Coafacwkutiyc Lic. No. (oss-at! Class
®® Contractor's E-mail Address
_-- _ 4w+..:. rrtq�cs(e G«sk'c�(•M a�w.wil,ca�.
State C.Aj Zip 9Lg(<4 Telephone
714-7_o4Poo8 3
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
PERMIT NO. kie,2oZ3 - Q?fj//�
PLAN CHECK NO. ;PG f10 3, 0 � c
PLAN CHECK FEES $