HomeMy WebLinkAboutXR2023-2493 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
j- Cor.rlm'I (- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
j-Building F-Grading r-Drainage (-Elec r-Mech j-Plum cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood r Fire r Liq r Landslide f N/A Floor Suite No
Description of Work �j p^ Use I ConstType F-
# Stories Z # Units (if Res)
New/Add SF�- Remodel SF
OWNER'S NAME Last
Owners Adaress 1
City N
Valuation $
Garage/New/Add Material/Labor I oi.S�w
(SQ�� )40IN First
State I Zf4ht Zip I f�A_ Telephone
APPLICANTS NAME Last 1 Stk t`11,
Applicants Address
123 41 GR*JUodJ C-st
City _ 51�ct iCPc (DI AN State
ARCHITEC rIDESIGNER'S NAME Last F_
ArchitectlDesigners Address
City - State
First
Applicant's E-mail Address
S4NkvSM <ek-g -�) 4,—V )L i Y
Zip � D� :_ TelephoneF �l � t I Q(
Fi st i Lic. No. F—
Architect/Designers E-mail Address
Zip �— Telephone)
ENGINEER'S NAME Last First i Q (� t1i (yi Lic. No.I 5 oZ!Sq
Engineers Address Engineers E-mail Address
157'l-o d2oo)t-�ADU-ow, 4s iGlkuNr�.a �11�C�1f� GaM
City State I Ck Zip Telephone -7 j b
CONTRACTOR'S NAME/COMPANY
Iqw�JS �� I`E / OtV Lic.No. 7440 Classi�
Contractors Address Contractors E-mail Address _
--
City S�NtR� State
SETBACKS REAR
SETBACKS FRONT
SETBACKS LEFT
SETBACKS RIGHT
USE ZONE
DEVELOPMENT NO
zip l Telephone
4a S 17r �
PERMIT NO. )(R1073 • ?-4'93
PLAN CHECK NO.
PLAN CHECK FEES $