HomeMy WebLinkAboutXR2023-1239 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application 03-
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r Comm'] r Residential City of Newport Beach - Building Division )�
PLAN CHFCK FFFS rL 1❑ AT Tnneo nv CI lo...In AI _
--''• •iiv—— VvulllllI IML
j�uilding j- Grading F-Drainage r Elec r Mech F Plum CuvdCut s— cuYdFill
Project Address (Not mailing address) r Flood
j- Fire r Landslide I -N/A Floor Suite No
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Description of Work
UseKFi�5onstType FvE
# Stories # Units (if Resf
Valuation $ F
Material/Labor
New/Add SFF— Remodel SF�—Garage/New/Add
OWNER'S NAME Last '
ovl.C,f,�
Y ,
First
Owner's Address
Owner's E-mail Address
City
N YM1 J'j1 \ State
C/ ZiP
"�� �; L Telephone Tz 6, 2z z 2- c L //
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APPLICANT'S NAME Last �''\_
Applicant's
First
Address
Applicant's E-mail Address
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Tale`, one �l
City I GL yl G( ���'r 1 I- State Zip 9�(�
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ARCHITECT/DESIGNER'S NAME Last -L�— Lic. No. �—
� �7�t/�� ��, LLV��LL. First
d es3-
r'A�chitAct/De gner's A�
Architect/Designer's E-mail Address
City State �_ Zip �— Telephones--
��IGINEER'S NAME Last
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First F E7 F Lic. No. & 7'/6t (
Engineer's Address Engineer's E-mail Address 7) L� T f`1 � /
City � State
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Ctz Lin l'r Q
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q � Telepho(�
CONTRACTOR'S NAME/COMPANY %]J�/'_
I (� �e
j�V� ^n^^^ Lic. No. o ClassFe�—
Contractor's Address Contractor's EE--ma'il Address
City 5�,� / f State G Zip C Telephone-
v F(�13 yS I 53 t, `3323
SETBACKS REAR SETBACKS FRONT
PERMIT NO.RZly 23, i Z39
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. f'C ZOZ3 - �d9g
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $