HomeMy WebLinkAboutXR2023-1364 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
f Comm'I F (Residential City of Newport Beach - Build;
f-Building
Project
Iz9
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F Grading
j`Drainage F Elec F Mech
f Plum Cu
Address (Not maili
VIA- JUGS.
Description of Work
address) F Flood Fire j Liq [_ Landslide
Cu Yd Fill
j_N/A Floor
Suite No
- Gm rS5'Fp- Use Const Type
" 9 # Stories # Units (if Res)[_
New/Add SFF � Remodel SF i Vauion $ // Garage/New/Add �� IMalteartial/Labor°i2/ �l/Q
OWNER'S NAME Last I r` j-2;t �
—N
(p Ll2 C -- (, First
Owner's Address -Y C_ t �
Owner's E-mail Address
City �� oL G6/vj
State Zip %
/ Telephone �7,0ryy
APPLICANTS NAME L -5
Applicant's Address Last First
F_ Applicant's E-mail Address
City State �-
Zip F Telephoners
ARCHITECT/DESIGNER'S NAME Last Ac nA �� � ) 64 First � �
Architect/Designer's Address Lic. No. C
Architect/Designer's E-mail Address
City / v6 (W / State—�_—/---
r` y � /�V � `-'�T Zip Telephone
/ 7 4`
ENGINEER'S NAME Last
First I .. r'---'---
Engineer's Address
Lic.
— Engineer's E-mail Address
City
State F Zip F Telephoned
CONTRACTOR'S NAME/COMPANY
Contractor's Address
Lic No. F� Class F_
Contractor's E-mail Address
City I State F_
Zip �— TelephoneF�
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT PERMIT NO. � 2 _ L? k
SETBACKS RIGHT
USE ZONE PLAN CHECK NO. -
PZ
DEVELOPMENT NO PLAN CHECK FEES $