HomeMy WebLinkAboutXR2023-2491 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division _
r Comm'] r Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F Building j- Grading F-Drainage I-Elec I-Mech
r Plum Cu Yd Cuts Cu Yd Fill �
Project Address (Not mailing address) Flood
F_ Fire (— Liq r Landslide F_N/A Floor Suite No
Description of Work
Use s Const Type s
# Storieslia # Units (if Res)s
Valuation $ 1 U Sod
Material/Labor �
New/Add SFS Remodel SF �— Garage/New/Add i
OWNER'S NAME Last �L �l C�I�i� �C)(-V First
Own -eft -Address Aa ress
Owner'sE-mail
b-DI
City State 1 (7,(4
Zip Q�S TelephoneF1 R _�j �3
APPLICANT'S NAME Last! SM t t 1
First t jGegs
Applicants Address
Applicant's E-mail Address
City State G�-
Zip 1 �`��5 Telephonej�l4 9 t
ARCHITECT/DESIGNER'S NAME Last
First I Lic. No. --
Architect/Designers Address
Architect/Designees E-mail Address
City . � � State F_
Zip �— Telephoner ------
ENGINEER'S NAME Last , x i I, D
First /�) R N (� Lic. No. S 2
Engineer's Address
Engineer's E-mail Address
1 SAD �CtDb1��6 ou,ow 0- 4S
°r-H JNl-o R&V
City (fin r State �/' f�
Zip IR �'7 ds Telephonel -7i 4
CONTRACTOR'S NAME/COMPANY 9US 4�l to GQ NSr Lic. No. 3-744 v Class
Contractors Address
Contractors E-mail Address
City �, �(� State
Stir[ t-
Zip "127 b 5� Telephone, /I k
SETBACKS REAR SETBACKS FRONT
ry �j
PERMIT NO. )(RZQG J- Z491
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $