HomeMy WebLinkAboutPV2023-0343 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application a" °ar
City of Newport Beach -Building Division � g
r Comm'I Residential NOTE; PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding rGrading rDrainage KElec rMech
rPlum CuYdCut F CuYdHIF
Project Address (Not mailing address) i— Flood
r Fire i— Liq (-- Landslide FN/A Floor Suite No
Description of Work
Use F—ConstType
� 5✓� // 4 6 0 -M 0-Al
# Stories #Units (if Res)
ry !3 /14nc 15 /3 m,Zw-ry i�y� �L, s
New/AddSFF Remodel SFF—Garage/New/Add
Valuation $
Material/Labor �000
OWNER'S NAME Last �6G��
FirstFPG7'e��L
Owner's Address
Owner's E-mail Address
�GrltCIlc%, l0o(0) r.,Y eve
City /L !2 State lz
Zip F Telephone`
APPLICANT'S NAME Last /nlLr til First
Applicant's Address
Applicant's E-mail Address
'z33 Cy
tv Ldcn;(sv�a�c'�Y,
City LOh ��j �LorC,� State VC,
Zip F5CS10-F Telephone( L 2 y`/ -S,So
ARCHITECT/DESIGNER'S NAME Last
First F— Lic. No.
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
City I State 1
Zip F TelephoneF—
ENGINEER'S NAME Last
First Lic. No.F_
Engineer's Address
Engineer's E-mail Address
City State �—
Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY / �- n �✓
/u J� �� L Lic No. 3pG y $ 3 Class -AD
Contractors Address
Contractor's E-mail Address
z33 &/'
�4 L dC-ne(/ s Ole, l /• c a
City L C. /��--4 State 74
Zip q0T0 F Telephone S; 2 ' VV -SZ S ct
6f' jC,411r �, � '
SETBACKS REAR SETBACKS FRONT �1j1 r• . ,- `;
,Y3 I PERMIT NO. v � � ✓ � ' ..1-;1
SETBACKS LEFT SETBACKS RIGHT 11 IL t t PLAN CHECK NO. �1 • (''� %' k P
USE ZONE DEVELOPMENT NO`� f
PLAN CHECK FEES $