HomeMy WebLinkAboutXR2023-1368 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
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Comm'I Residential
City of Newport Beach - Building Division
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Description of Work
Use ConstType
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# Stories #Units (if Res)
Valuation $
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New/Add SFF� Remodel SF F Garage/New/AddMaterial/Labor
OWNER'S NAME Last ct /I IG�� -S �L•r
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First C- �GS���-C4
Owner's Address
Owner's E-mail Address
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City n! Vj State Fz
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APPLICANT'S NAME Last vvl wrc� -C
First J-3 ky
Applicant's Address
Applicant's E-mail Address
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City (,CtSv.N4 %rl(5 State �—
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ARCHITECT/DESIGNER'S NAME Last
Lic. No.
First F �—
Architect/Designer's Address
Architect/Designer's E-mail Address
City I State F—
Zip F_ TelephoneF_
ENGINEER'S NAME Last cis-/ y
First Lic. No. Fc,7 1113
Engineer's Address
Engineer's E-mail Addddress
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City �IL State
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CONTRACTOR'S NAME/COMPANY /( ,e�") VA _/��r�N/�S Lic. No. 79�g�(y Class
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Conttrra{ct�or's Address
Contractor's E-mailAddress
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SETBACKS REAR SETBACKS FRONT
PERMIT NO./
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. Z,G w
USE ZONE DEVELOPMENT No
PLAN CHECK FEES $