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HomeMy WebLinkAboutPV2023-0422 - Permit ApplicationPrint Form IWorksheet for Combo Building & Solar Permit Application r Comri r Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL rBuilding r Grading rDrainage r Elec rt Address (Not mailing address Z `I Descripti I n S f R 11✓ai5; (e 1 Ve of Work qi, 0 5 k W Arag to U 05 u to M'�rofnVa/Ft�S. 1,7SifIlrn1 r Mech r Plum Cu Yd Cut Cu Yd Fill r Flood r Fire r Liq r Landslide 5 o(¢r Mo d41Ps w rN/A Floor Use F— ConstType Suite Nc # Storie # Units (if Res)[— C If'btn rr 4A C D,sa�n rct New/Add SFF- Remodel SFF— Garage/New/Add �— OWNER'S NAME Last TI{ fClio r- FirstI CArrS Valuation $ l SBA Q Material/Labor J Owner's Address 4 za e Owner's E-mail Address l�,oll`re +ree(o)g-t4tr'l,re, oi City �1/C,/pal_f 13BtC State �t G R Zip 9Z 6 63 Telephone CR 4Q) K;; —r� b 6 APPLICANT'S NAME Applicant's Address gol f4lenntbyre Last Go�f�P�a City I t t 911 g egCN State L A ARCHITECT/DESIGNER'S NAME Last Architect/Designer's Address First I xn kI e ✓ Applicant's E-mail Address XQvI'QStdIPrSo(nl CB',J Zip 9Z 115 ( Telephonl S tZj 63 y - 97S7 First Lic. No. Architect/Designer's E-mail Address City State F— Zip-- � TelephoneF� ENGINEER'S NAME Last 7 k p f„ z1 z 9 First �� a e y Lic. No. r-- Engineer's Address Engineer's E-mail Address event'/neels net City State �-- Zip F— Telephone[� CONTRACTOR'S NAME/COMPANY a�V 1 -. i �I ot/Lic Class No. �— Contractor's Address Contractor's E-mail Address City I State F_ ZiP F_ TelephoneF� SETBACKS REAR SETBACKS FRONT FLAN T NO. / 1 SETBACKS LEFT SETBACKS RIGHT uj V CHECIZ USE ZONE DEVELOPMENT Nn ni All i—.1 ,.