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HomeMy WebLinkAboutXC2023-0336 - Permit ApplicationWorksheet for Combo Building & solar Permit Application C Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL=:a U Grading [,Drainage.Elec ech plum Cu vd Cut Cu vd riilV�\ 111 1 [ 11 roject Address (Plot mailing address) [l Flood [ Fire ❑ Liq 1-1 Landslide 1-N/A Floor Suite No Description)) of Work Use T 1� YP �hl!<�Y /�, onste /,� h1 t r UN -r�i(®_ �� T k StoriesTI # Units (if Res(-] New/Add SF Remodel SF[--—Garage/New/Add-� Valuation $ Material/Labor OWNER'S NAME Last - - _ 1 ✓ICU t/ Wli_�/-1� First --------- —-- Owner's Address [" Owner's E-mail Address City 1V State C Zip Z Telephone -j' . I lylJ APPLICANT'S NAME Last First RAP—k _ Applicant's Address Applicant's E-mail Address J City _Q�}•+L{jj-_ I State _C�lj—� Zip Zf�%J� Telephone ^Z-^-�7v - — FI-_ LicNo.ARCHITECT/DESIGNER'S NAME Last_ � "l% First ArchitectlDesigner's Address Architect/Designer's E-mail Address 6>- City )Jrtrt/0;✓p t�:c� Stale - f'\ p Z�,p �� Telephone ENGINEER'S NAME Last 11 First Lic No. Engineers Address Engineer's E-mail Address -- -— ---------- I -- City _ _ -_ - State �i Zip Telephoned CONTRACTOR'S NAME/COMPANY I Lic No. - i Class - — Contractors Address Contractors E-mail Address City State Zip Telephone �,1 SETBACKS REAR SETBACKS FRONT - PERMIT NO. hC�[20 Z3 0336 SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. PC201n - ?-(JqC+ USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ 61li I TaAw