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HomeMy WebLinkAboutXR2023-2012 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application F Comm'I ( Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL FMBuilding r Grading (—Drainage F ElecIFMech ( Plum cu vd cur— cu vd riil I Address (Not mailing add u�l ►fiy) In of Work New/Add SFF — F Flood r Fire r Liq r Landslide be/ fum.Q ��t 10i 11 Remodel SF Garage/New/Add �— OWNER'S NAME Last I ✓ First f—WA Floor Suite No Use Const Type # Stories # Units (if Res)F_ Valuation Material/Labor Owner's Address I "yw//y - - _ 3G5 Owner's E-mail Address _ C�crt417'on .Ave.. city w d f r JC*60 �i^�S�i4c }tr�sw c.�dm NR f✓G �G State Zip Telephone 7/y357,0W,d APPLICANT'S NAME Last Applicant's Address 7b5 d�/le _�✓lv r 5✓f�e �. City N [ t StateFL ARCHITECT/DESIGNER'S NAME Last Architect/Designer's Address City ENGINEER'S NAME Last Engineer's Address City CONTRACTOR'S NAME/COMPANY Applicant's E-mail Ad/dress - yblyre am�i4aGca�� ����vjjj 111(A Zip lW51 Telephone Y- First I Lic. No. F — Architect/Designer's E-mail Address State �— Zip I TelephoneF — State �— First Lic. No.F� Engineer's E-mail Address 6vo L(;s Zip F� TelephoneF� Arnb144 6 � If j�!/�j Lic No. 51� �-77� Class Contractor's Address J 70 Contractors E-mail Address City State l.�,Pil�/ 9✓y%Cj/9'19G2u(/ 1 ' C/u�y�� w I �' — Zip n f P M p Telephone, ele hone 1/ y.y3o „33 SETBACKS REAR SETBACKS FRONT SETBACKS LEFT USE ZONE SETBACKS RIGHT DEVELOPMENT NO PERMIT NO. j&1NV43-.in, PLAN CHECK NO. PLAN CHECK FEES $