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HomeMy WebLinkAboutXR2023-1286 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application F_ Comm'I F_ Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL jRBuilding Grading F-Drainage r Elec (—Mech r- Plum CuYdCut CuYdFill F Project Address (Not mailing address) f— Flood r Fire j— Liq F_ Landslide FN/A Floor Suite No I70 SfdneYBq Dr ( F— //�� Description of Work rf. el-'{ Ik Use F— ConstType (A5fgiltap 29 U;�[V 50111- p14els w/ S0l r0l p #Stories #Units (ifRes)F_ rn�e/fP/`r Cluj+fl�rA� Z Ly 66H b17��les. Valuation Material/Labor -1 ✓ New/Add SFF Remodel SF�— Garage/New/Add OWNER'S NAME Last O C n f S p ji First I rAp vt Q S Owner's Address Owner's E-mail Address i70 StdnPX B py D Jx 41IQ)'1,roM City FIV e P p #, I U e l h State C A Zip qZ 6 S 1 Telephone f y 9 4 31 Q0 ? 0 APPLICANT'S NAME Last - t erZ S First I X 4 ✓t i r Applicant's Address Applicant's E-mail Address 8fll 41eon5 r,-) S441ersDltrrcc/y, city L 4 q it g eat h State F c ft zip q 2651 Telephone (56z) 637-975 7 ARCHITECT/DESIGNER'S NAME Last a n Z/ Z q First � e g�c9 3 M 4 g y E �19P�1 Lic No. Architect/Designer's Address ArchitecUDesigner's E-mail Address pIQje05 e✓dn)ifieolSAeJ. c/n City State F Zip F— TelephoneF_ ENGINEER'S NAME Last First Lic. No.1— Engineer's Address Engineers E-mail Address City I State r— Zip �`— Telephoned CONTRACTOR'S NAME/COMPANY /)n e `q iI f Lic. No. �8z5 33 Class r J Contractors Address Contractor's E-mail Address al einey"t Sf- STE it M;/ceIV 5g91et57vI ,ovi City L () y Ar L.,fCh State I L ZiP y2 65I Telephone 9 yy_ ssti lig O p SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. )Oev2r>� USE ZONE DEVELOPMENT NO PLAN CHECK FEES $