HomeMy WebLinkAboutXR2023-1729 - Permit ApplicationL Print Form Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division
( Comm'I �Z Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL U = z
F-Building F- Grading F-Drainage F- Elec F_ Mech F- Plum CuvdCut F CuYdFw l `
Project Address (Notmailing address) F- Flood F _ Fire F Liiq F. Landslide F-N/A Floor Suite No
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Description of Work
Use k_3 ConstType
Cro�V CA
A
# Stories? # Units (if Res)[
Valuation $ /
Material/Labor G GEC �.
New/Add SF Remodel SF ( p Gara a/New/Add
g F
OWNER'S NAME f
Last First 7L4
Owner's Add//ress11 Owner's E-mail Address
City F State 6
I l„+t; Zip C' y,(.jt- Telephone
APPLICANT'S NAME Last First L
Applicant's Address J Applicant's E-mail Address
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ro✓'l'i _ _ 1�n c�.vl Vi i.�e""$i C:1 p�.�-�-_ _It� IVLk,
City State ( Zip rj l (J 3 Tale phone
p 5tz t94 737
ARCHITECT/DESIGNER'S NAME Last ('ul�,,� First Lic.No j?_3rj((uy_
J
Architect/Designer's Address Architect/Designer's E-mail Address
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City -1
Cy .C( t v�ct State Zip �� t f J.� Telephone `yf I � j ¢ 7 3
ENGINEER'S NAME Last O ti First U rLco Lic. No. S-csr4
Engineer's Address Engineer's E-mail Address
0+413L _ _ T%rL
City Ut1�C� State Zip �r y4 Telephone Z� Z.I 2 i'
CONTRACTOR'S NAME/COMPANY _ ` i Lic. No. �C A G C+ Class (�
Citt i 11cci t.ti / LL
Contractor's Address Contractor's E-mail Address
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City \ 1, r` Ci� State r Zip '� ��5 -- Telephone �Z4 Ts
SETBACKS REAR SETBACKS FRONT PERMITNO. o22 �Q�2
SETBACKS LEFT SETBACKS RIGHT N CHECK NO. XF-�45
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $