HomeMy WebLinkAboutM2023-0049 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application
F Comm] r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
I building I Grading (—Drainage r Elec r Mech r Plum CuvdCut s CuvdFill s
Project Address (Not mailing address) F_ Flood r Fire (— Liq F— Landslide Floor
Suite Nc
i(o V1 A— LiDr, ).)off 6 �— F—
Description of Work
Use Const Type
IS�Us �Ss (avaAq� ens .�' ,..ri �E�-cJ.�
# Stories # Units (if Resf
Z( t L 3 l a
New/Add SF s-- Remodel SFF Garage/New/Add �—
Valuation 5 ur
Material/Labor'
i
,
OWNER'S NAME Last First ^
`�
Owner's Address
Owner's E-mail Address
City State r--
ZIP f -- Telephone --
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
2ts" r a
0
xi 5�N �l 23 �Gr�t��, Gat1
City State 4�.Z Io _ --
Fe,
Zip 7 Telephone 1 " s i>Ze'
*tZ
,Z
ARCHITECT/DESIGNER'S NAME Last First F— Lic. No. �—
Architect/Designer's Address Architect/Designer's E-mail Address
City State F— Zip F_ Telephones --
ENGINEER'S NAME Last First F_Lic. No.s--
Engineer's Address - Engineer's E-mail Address
City - State �— Zip F_ Telephone
CONTRACTOR'S NAME/COMPANY. - `, i : 0 Lic No. F. --Class
Contractor's Address Contractor's E-mail Address
City _.na I�1Lt'S�,,l State F1 Zip CI 2 L L Telephone .� I �- z% I J
SETBACKS REAR SETBACKS FRONT PERMIT NO. M 00%3 _I
t'3,,2Q.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK
USE ZONE DEVELOPMENT Nn .,, .., ,., ,�,,,. ___.. _