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HomeMy WebLinkAboutXR2023-0166 - Permit ApplicationPrintForm Worksheet for Combo Building & Solar Permit Application F- Comm1 r Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL v rBuilding [ Grading j—Drainage [Elec F_Mech Plum CuYdCut cuYdFill F Project Address (Not mailing address) C Flood r Fire r Liq i— Landslide FN/A Floor Suite No .t�iV 2© J� CFj,2_ Description of Work Use �J' 11 Const Type J =AL 7�yx i lloAj 2 2� # Stories # Units (if Res) Valuation $ ' Material/Labor 4 New/Add SF f — Remodel SF F Garage/New/Add �— OWNER'S NAME Last L4'0� 6v`AnVoA LV-, First Owner's Address Owner's E-mail Address `f (9 604__�DjN LLc 6Jh C e'7 City (4$ , State z _ _ n-• Zip ,°,�, 7-7 Telephone �f Yc yJJ APPLICANT'S NAME Last First Applicant's Address Applicant's E-mail Address ((/0 `VALLELtvo 2,� City (nJ j Z 2 i n State FUT Zip T> J 13 Telephone �F�0 - ARCHITECTIDESIGNER'SNAME C/�� Last / First �� � 2 }� Lic. No. �— Architect/Designer's Address Architect/Designer's E-mail Address -.__- � - h'\ice/3C.-E�.C-cl (h�i�.c'-).�+ /t C� l Telephone (i — 'i 7S- O U �3 City C.7Si/� )1'l� 5,1 State ' ZIP `f�E�,6 I ' ENGINEER'S NAME Last First �® Lic No.F_ Engineer's Address Engineer's E-mail Address City State Zip �— TelephoneF— CONTRACTOR'S NAME/COMPANY 7 _ ILc � , P ' A� bt'� i ci-� � � C Q R LIC No. Class� _ Contractors Address Contractor's E-mail Address 7 c City (1,3� P I N t G J A State Zip tl 3 ` 3 Telephone a 0 J -4 `> l of % /,;2 SETBACKS REAR SETBACKS FRONT PERMIT NO. X�+'-/ - 0I (,P V SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. aVJ.2j, ptto4 USE ZONE DEVELOPMENT NO PLAN CHECK FEES $