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HomeMy WebLinkAboutXC2023-0500 - Permit ApplicationPrint Form vcomm'I r Worksheet for Combo Building & Solar Permit Applica ion Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL F_Building r Grading r-Drainage F Elec r Mech j- Plum CuYdCut CcYdFill e Project Adddqress (Not mailing address) ( Flood F_ Fire F_ Liq r Landslide FN/A Floor Suite No j Description of Work Use ConstT e YP , U✓✓1 # Stories[— # Units (if Res)F 26) + Ih + . •nJ t / 5 ia/Y� S _ Valuation New/Add SF F Remodel SF F--r Garage/New/Add I $ Material/Labor IJ69 or OWNER'S NAME Last 1 rY / 2-_ C G mew), First Owner's Address Owner's E-mail Address IIc),Tnncr3,�i'on DC), rI,Jn0 City Tr State c-*i Zip ?_,5i/ 7 �Tete¢hone lY'3 7011)G V t'r\ APPLICANT'S NAME Last M w First (e s .5 Applicant's Address Applicant's E-mail Address City 10 State I C- Zip Telephone q-c>l f - © ARCHITECT/DESIGNER'S NAME Last First �� Lic. No. Architect/DesigneCs Address Architect/Designer's E-mail Address City � State f — Zip F Telephone[ -- ENGINEER'S NAME Last First F_ Lic. No.F_ Engineers Address Engineer's E-mail Address City State Zip Telephonel— CONTRACTOR'S NAME/COMPANY C' J �t � G Lic No. I q-3(,,C>4Class C'q j" Contractor's Address Contractor's E-mail Address ?" _ r33y m f=f S l C. S C.fJ�.t h- 7iCA - CZ J City State Zip 1 Telephone O SETBACKS REAR SETBACKS FRONT 2 -t -,>• PERMIT NO. SETBACKS LEFT SETBACKS RIGHT'L��. pZ9'� PLAN CHECK NO. l "- - • %9{j-4 USE ZONE DEVELOPMENT NO�426V) D2-8_'S7_ PLAN CHECK FEES 5