HomeMy WebLinkAboutXR2023-1352 - Permit ApplicationPrint Farm Worksheet for Combo Building & Solar Permit Application
r Corl Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F_ Building F_ Grading F-Drainage j`Elec Mech Plum Cu Yd cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood F_ Fire F- Liq (_ Landslide 1_N/A Floor Suite No
F_
Description of Work
Use; Const Type
yry N DOw izc _PL13C-EM f=N I b tF0VL_
# Storiesr S # Units (if Res)[_
Valuation $
Material/Labor Z O Z
New/Add SFr — Remodel SF �� Garage/New/Add Z
OWNER'S NAME LastF BcjoW N First (Dun CK
Owner's Address Owner's E-mail Address
City (�JCv.}'r,Y ( r� C State CA ZipF— TelephoneF-
APPLICANT'S NAME Last First �tJSl��r
Applicant's Address Applicant's E-mail Address
_
SC
City5's / State FCA Zip[ —Telephone emu; JUG ''c;f
ARCHITECT/DESIGNER'S NAME Last -SUS Q First I r✓lpl2 (G Lic. No. F_
Architect/Designer's Address Architect/Designer's E-mail Address
City cG;' �/� r A� c/� State Zip �6 ` , Telephone � r� �CQ • j { E
ENGINEER'S NAME Last First F_ Lic No.F—
Engineer's Address Engineer's E-mail Address
City State Zip Telephone[ —
CONTRACTOR'S NAME/COMPANY > > r Lic. No. 6
�grL67 L2� S< < � Class_
Contractor's Address Contractor's E-mail Address
City dnc wPo1�1 (?CzL,cN State Zip I Z6E 3 Telepho c113 �� _ -e_7
SETBACKS REAR SETBACKS FRONT PERMIT NO. X f,2,CY�3- /jS�
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $