HomeMy WebLinkAboutXR2023-2486 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
r Comm'I F- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[-Building r- Grading j-Drainage F_ Elec F_ Mech F Plum cued
eet Address (Not mailing address) F_ Flood [- Fire 7 Liq F_ Landslide
of Work
New/Add SF�- Remodel SF Garage/New/Add
OWNER'S NAME Last
JWIICI D/IUVIGao �
��1.6a First
Cu Yd Fill �—
F-N/A Floor Suite No
�--- F
Use Const Type
#Storiesll�_ # Units (if Res)F
Valuation
Material/Labor (�
City N \� State �— Zip 44 3 Telephonei90
APPLICANT'S NAME Last
Applicants Address
t,�34A0jjD?a CrORPro(:L
city C _ � fA IQN State
ARCHITECT/DESIGNER'S NAME Last
Architect/Designees Address
Firsts t-AA)G(Js
Applicants E-mail Address
Is
Zip 917 0SS Telephone )�
First F_ Lic. No.
Architect/Designer's E-mail Address
City State _ Zip Telephones
ENGINEER'S NAME Last Z
Engineer's Address
( S3 r7 ( �D E �6 G� c?W . �V �k�
City ^�- " m et, (� (J� State rC-4
First RW C Lic. No. �`$ 9
Engineer's E-mail Address
'�Nun►c�a �G—�—Ga-1`1—
Zip Iq/ (�S Telephonei'�'� 4 �61 LOS-10
CONTRACTOR'S NAME/COMPANY ��W GaNs Lic. No. I� � Class;
rP,��us S
Contractor's Address Contractor's E-mail Address
Iles o, CAN D1\J b rz r, p
City-�PN`'� t.yA _ StateF27 Zip � S Telephone714 S <g 1191
SETBACKS REAR -•��� SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. �C ZbL3 �210 lb
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $