HomeMy WebLinkAboutPV2023-0424 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application (1142
F Comm] F_Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FFGc ru ]MA771KA.111111-
"""-""--"-' � • wIJIVIIIIHL
FBuilding r Grading F-Drainage r Elec r Mech r Plum CuYdCut l cuYdFill
Project Address (Not mailing address) F_ Flood F_ Fire r- Liq j- Landslide FN/A Floor Suite Nc
Id 0 On x !'�A
F_ F_
Description of Work
s U Z.
Use F— ConstTyoe
-�, 0, rV e ��� ��
& U
Fs v s sit
# Stories #Units (if Res)
Valuation
valuationa
Material/Laborri�j
/
�o_5
vM,C
New/Add SF RemodelSF�—
Garage/New/Add
OWNER'S NAME Last �rS
First O Q��
Owner's Address
120
Owner's E-mail Address
Orl X�C
�r�s-�dz:ca
City IVStater G Zip Telephone
2�Z Pq-
APPLICANT'S NAME Last MU !l� �7
First
Applicant's Address
Applicant's E-mail Address
City State /S
Zip CI Telephone �LL 2q4- 5-2 U
/
ARCHITECT/DESIGNER'S NAME Last r First I — Lic. F_
No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City F— State �—
Zip [_ TelephoneF�
ENGINEER'S NAME Last F__
First Lic. Nof—
Engineer's Address
Engineer's E-mail Address
City State F_
Zip F_ Telephone[�
CONTRACTOR'S NAME/COMPANY < Lic. No. i C L03 Class
Contractor's Address
Contractor's E-mail Address
�L33 C
�r<y ':1�L'
��iUGII -Cti yt
City State �G
SG/Gl
Zip �ip�p S Telephone '17 S Z36
SETBACKS REAR SETBACKS FRONT
PERMIT NO. -7/ - Z)i2a 1
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT Nn