HomeMy WebLinkAboutXC2023-0074 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F' Comm'I F- Residential City of Newport Beach - Building Division o
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F-Building [Grading F-Drainage [-Elec F_Mech r-Plum Cu Yd Cuts Cu Yd Fills
Project Address (Not mailing address) [ Flood i- Fire f- Liq r Landslide CN/A Floor Suite No
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Description of Work
Use F—ConstType
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3
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# Stories # Units (if Res)s
Valuation $ /��� /�
Material/Labor ? 0W 0
New/Add SFF— Remodel SFs— Garage/New/Add -
OWNER'S NAME Last E) �` &ZI FJD- 007ikn1 FirsF
Owner's Address CvlSiNr LGC
Owner's E-mail Address
COI Al. SvV N S% 861ZCA-00 HODEgM.COH
city 5qy t Aice/) State C/A Zip /ZOO ( Telephone %fy 335, Z�/y6
APPLICANT'S NAME Last F�/�R�v7� -- — First SSE
Applicant's Address Applicant's E-mat ddress
301 N- S9u4 O/V C& RIzvDo @ H64CA90MOPFlenv COA
CityState � , - - -- � �ia- �i/�6� � Zip .-9Z�r7L. Telephone �� / 33i3_'L�l`�,6
ARCHITECT/DESIGNER'S NAME Last First Lic. No. I
Architect/Designer's Address Architect/Designees E-mail Address
20L-1 -A W LAI2Ietoo Ave
City L 0 f2 uln u, State 4�A Zip 92 0 6 �- Telephone ��H . l �% 7'
-- -- -
ENGINEER'S NAME Last First Lic. No.F
Engineer's Address Engineer's E-mail Address
City State Zip F Telephonef
CONTRACTOR'S NAME/COMPANY S I Al Sa U Lic. No. , - �6 Class F
Contractors Address Contractor's E-mail Address
6AIC I_. e to %�.9_ /` Ve �. IJ f21- UC O s'i w .'�O l)/2G� !^Alvl
City �/ yP State CA , Zip JZ86--- Telep one ��U._ q7 _
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. /Z ZvZ )
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $