HomeMy WebLinkAboutXR2023-1854 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
j- Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building F_ Grading j-Drainage r Elec r Mech
F- Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) f- Flood
j- Fire F- Liq r Landslide F_N/A Floor Suite No
2309 S,j,-TiAt o Do-
Description of Work
Use Const Type
New CM v Srf£ wp-vL S
sty. �1 `•
# StoriesF # Units (if Res)F_
/-
x Lit l r , i1 �4 Ly up -A �t (}.•
�y. O � 1! ��..
l
New/Add SF F_Remodel SFF— Garage/New/AddF
Valuation
Material/Labor
OWNER'S NAME Last I T3 Pi 00,1—
First P Q
Owner's Address
Owner's E-mail Address
7-30') .5/YjT-iA7io De -
City l+.lit, feer gWrT State FtJ
Zip F_ Telephone 4fr•(1 -1,9 -/4)6c�
APPLICANT'S NAME Last mck 110 yt,
First I grLh r
Applicant's Address
Applicant's E-mail Address
i-711v j• rJon �r ci
brev, aez bu, POD(3,cc:,"
City /�yp�Vrtr✓✓� State �'A
Zip ITTO Telephone ` tll_Liq— -5
ARCHITECT/DESIGNER'S NAME Last
First �— Lic. No. F
Architect/Designer's Address
Architect/Designer's E-mail Address
City I State F—
Zip F— Telephoned
ENGINEER'S NAME Last S j` /Lj £ /NG First F_ Lic. No. 2iL>`t o�
Engineer's Address
Engineer's E-mail Address
1800 �• 1641, N-atj f3
City S,1KI t State C�—
ZiP ja,"')� j Telephone ply - 83S -a
CONTRACTOR'S NAME/COMPANY TNT QoOL toNN£G�EN i1�L Lic No. rob�e5Ts Class g/C 53
Contractor's Address
Contractor's E-mail Address
17yJ L Voh.�,vY Gtr
6rc�ilQbutl)y001S.00"
City I AhahGtkit State �—
Zip q_o�7bo_� Telephone 7tYyour-�q3�
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. ULo'L-a7 • (�oijC�
USE ZONE DEVELOPMENT NQ�)LD t n — 07 PLAN CHECK FEES $