HomeMy WebLinkAboutXR2023-1626 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F Comm] Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FFFR nl IF AT TInnF n❑ ci 1QftA1TrA1
14uilding F_ Grading j-Drainage F Elec r Mech /// "' r Plum Cu vd cut Cu vd Fill
Project Address (Not mailing address) F_ Flood r Fire F_ Liq r Landslide rN/A Floor Suite No
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Description of Work
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Use F—Const Type F—
# Stories # Units (if Res)
Valuation $ Oo
Material/Labor
New/Add SFRemodel SF�— Garage/New/Add F
OWNER'S NAME Last
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P)A-9li �.L`i First 0 l- L_
Owner's Address
Owner's E-mail Address
City tAe �� i3-.
State I A p Zip a Telephone 3--7-700
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APPLICANT'S NAME Last
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Applicant's
Applicant's E-mail Address
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City
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State Zip Telephone
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ARCHITECT/DESIGNER'S NAME
Last go 66First e��Y Lic. 2e t/
No.
Architect/Designer's Address
Architect/Designer's E-mail Address
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City q__&W t ber reeAo�� State L', A�— Zip 9 _ o Telephone 'N I - TS-0- -7-S
ENGINEER'S NAME Last
�J' f � U I- I C First e" Lic. Nof 5 9q 9 }
Engineer's Address
Engineer's E-mail Address
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City NQrJOit- O(4cr,
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State Zip 9Z64e Telephone[
CONTRACTOR'S NAME/COMPANY
Z 1 k4s�- Lic. No. I ep IIJssF 7�57
Contractor's Address
Contractor's E-mail Address
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City
State ZiP C�ZGZ_7 Telephone gt4l. 3��7.30
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SETBACKS REAR
SETBACKS FRONT PERMIT NO. KC2dti;5 - I
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. PC.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $