HomeMy WebLinkAboutXR2023-2666 - Permit ApplicationPc,R
Print Form Worksheet for Combo Building & Solar Permit Application
r Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F_ Building r Grading rDrainage r Elec F_Mech (— Plum CuYdCut CuYdFill F
Project Address (Not mailing address) F_ Flood r Fire r Liq r Landslide FN/A Floor Suite No
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Description of Work
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# StoriesF_ # Units (if Res)
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Valuation $
New/Add SFF Remodel SF Garage/New/Add
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Material/Labor W
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OWNER'S NAME Last =tLG N First .w Srx n3
Owners Address Owner's E-mail Address
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City I CoStLt Ill eJh State L� Zip 7Z�Z1 Telephone FY, T-) 1,/94
APPLICANT'S NAME Last L( 7rJ F� First �.
Applicant's Address Applicant's E-mail Address
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City I A(Ae Y'077 State I zip �/j-2— Telephone F(T5.7(_ 7(�
ARCHITECT/DESIGNER'S NAME Last Lic. No.
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First 'v"i / I —
Architect/Designer's Address Architect/Designer's E-mail Address
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City (�- l� '/ :r/ State (A Zip aJWG,, Telephone 7?e 3y,/+_ -I(: c,
ENGINEER'S NAME LastFirst �Gl'19�t� Lic No.
Engineer's Address Engineer's E-mail Address
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City MU�(Ic� State �{ Zip Telephoned
CONTRACTOR'S NAME/COMPANY Lic. No. F ClassF
Contractor's Address ` Contractor's E-mail Address
City State F— Zip F_Telephone�—
SETBACKS REAR SETBACKS FRONT PERMIT NO. Q'fI • Z61D
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.?G201.- Z3Z6
USEZONE DEVELOPMENT NO PLAN CHECK FEES S