HomeMy WebLinkAboutXR2023-2242 - Permit ApplicationPrint FormWorksheet for Combo Building & Solar Permit Application ozEW�a>e
r' Comm'I [- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
VBuilding [- Grading [-Drainage F Elec [- Mech
[- Plum n,ydCut s CuydFill s
Project Address (Not mailing address) [- Flood
r- Fire r- Liq r Landslide r N/A Floor Suite No
Lq o L Ct+ 4LJ s t
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Description of Work
Use ConstType��j
# Stories? # Units (if Res)[
Valuation b ��
Material/Labor F1 `
New/Add fj' SF P-Remodel SF �l � 5 �arag
a/New/Add
OWNER'S NAME Last FWt—E
First LC ffA-F C_
Owner's Address
Owners E-mail Address
a@ Co liters . C o m
City �� E."-C��" State
1daO ' �
Zip -S' a9
26C Telephone 9 9��%
APPLICANT'S NAME Last Cou-5pla
First Cg
Applicant's Address
Applicant's E-mail Address
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artc- e "v I aj`cIL•6CwA
City �L7 �f%� �� � State CA
Zip �d 6� 3 Telephone (j',f `j-Y3Y-Cf (3
ARCH IT�ECCTr/DESIGNER'S NAME Last � G� First �— 3D
L L Lic. No. �
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
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e(`i e- 4 oI & i, t,h • c7Y Y)
City , I
C � ca State ��
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Zip b6 7 Telephone
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ENGINEER'S NAME Last 6e,
First (� �r �� Lic No.
1
Engineer's Address
Engineer's E-mail Address
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i��LK e U &PC4. CD.o
City R�ryt„' L State C�
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Zip K9 b 4.j Telephone / �E_[I -S-Wy- q f
CONTRACTOR'S NAME/COMPANY i 4 �I l (! E7 j�r� Lic. No. pj�i� t( (Class
1
13L91 ��`Kf .
Contractor's Address
Contractor's E-mail Address
Cl Pe Sr cT
%-CLCIN ocklct,Fr t1 cr' J'dtwr . Cc>n�
City ( f4 f1d for' K 14 State I ` !-f
Zip r/� Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO. c Z.
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SETBACKS LEFT SETBACKS RIGHT
I t C PLAN CHECK NO r _
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $