HomeMy WebLinkAboutXR2023-2488 - Permit Applicationo��ro o
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
F-Building (-Grading F-Drainage rElec r"Mech F_Plum Cu vd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood i- Fire Liq F Landslide i-N/A Floor Suite No
Description of Work Use ConstType
i- # Storiesj— # Units (if Res)F_
Valuation $
�— l v,
New/Add SF_- Remodel SF�— GarageMew/Add Material/Labor, -
OWNER'S NAME Last, First
�N4.wPo¢
Owners Address Owners -mai ress -
� 0 Nrvv �' 2 �� I
city State Zip Telephone) 9 641 33q.
Ur
First 1 0,ti GS
APPLICANT'S NAME Last F5F& I I ��i
Applicant's Address Applicants E-mail Address
G('tNHDo C
LI�_,moo
State ZpGNllephonei� f 4 SaOIn
city SQWP
—
ARCHITECT/DESIGNER'S NAME Last First F Lic. No. �—
Architect/Designers Address Architect/Designers E-mail Address
City �- State �— Zip - Telephoned----
ENGINEER'S NAME Last X First's Q I cl Lic. No. q
Engineers Address Engineers E-mail Address
city �N State i (1 Zip �I�e� Telephoneii 14 �j(�/, 0SID
-� A-
CONTRACTOR'S NAME/COMPANY -c�.I
Lic No. 67 4 Class
Contractors Address Contractors E-mail Address
�1141 CSt IJ j mi
(_ �7 1
R^ � Telephone,;
City F� _ �� State Zip , 4 �J'E `/q /
SETBACKS REAR SETBACKS FRONT PERMIT NO. XRZOZ3� 2488
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $