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HomeMy WebLinkAboutXR2023-2492 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application o71572P f Comm'I F Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL F_BuildingF— Grading rDrainage F— Elec j— Mach F— Plum Cu Yd CutF Cu Yd Fill F Project Address (Not mailing address) F_ Flood F— Fire F- Liq F- Landslide I N/A Floor Suite No I 10 K I -F Description of Work Use [_ ConstType (� # Stories #Units (if Res) Valuation $ F)DI O� Material/Labor New/Add SF�- Remodel SF�— Garage/New/Add I OWNER'S NAME Last �� fn/(�it CZ �{Z =fj; I-+p(y, First I Owners Address Owner's _m a il Address — — t �N`vCZti ill � ST p / City _ �� State �j�n _ zip �!� TelePhonel 7 [fQ 4, 323 �1 + First NS APPLICANT'S NAME Last I S Applicant's Address Applicant's E-mail Address City �' _� (� - State Zip �- 7os Telephone ' 1 <iwq I t `E6 ARCHITECT/DESIGN S NAME Last First— Lic No. �— Architect/Designers Address Architect/Designers E-mail Address City - - -- State �— Zip I Telephone_-- ENGINEER'S NAME Last X I A D First CX i A / Zr Lic. No. S g9 Engineers Address Engineer's E-mail Address If 50-0 ZaDO K.IAOVI, awl +f iz,,4 Ou NU -a RQY .Go,M �—ry City S[�(� (1 �� State Zip I�`�"��S Telephone �I `[ I I D CONTRACTOR'S NAME/COMPANY Z USSi�t; Ik C p/SY Lic No. F4374/40Classl Contractors Address Contractors E-mail Address f�34� ��r��►b���� ! s��►� �- Nt�� �� City `� State I G(� Zip I ��� ps TelephoneIn SETBACKS REAR SETBACKS FRONT PERMIT NO. XR2023 — 249Z SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $