HomeMy WebLinkAboutXR2023-3301 - Permit ApplicationPrint Form I Worksheet for
Comm'I I— Residential
NOTE:
Combo Building & Solar Permit A ation EW POgf
City of Newport Beach - Building Division ''q 1
PLAN CHECK FEES DUE AT TIME OF SUBMITTA
FBuilding F Grading F-Drainage i-Elec Mech
j Plum cuYdCut F cuYdFill ��
Project Address (Not nailing address) I Flood
r Fire r Liq j Landslide F_N/A Floor Suite No
F_ F—
Description of Work
Use ConstType s
# Stories # Units (if Res)s
lYlai>clt ,�k k,4t 'A�f_+v..Pt6, t'1P—
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New/Add SFF Remodel SF (-.! J Garage/New/Add
F
Valuation $
Material/Laborl�h✓/
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OWNER'S NAME Last fir,-, v,�<';
First i r,
�_ � r,,�, ^J '-,5 f �, : ; q
Owner's Address
Owner's E-mail Address
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City I I1nw�� ._ 1._.> r State c ��
Zip �U, i, o Telephones
APPLICANT'S NAME Last j
First
V�Y'tt,ie A,--�
Applicant's Address
Applicant's E-mail Address
'Y-;vrke e _C
City I h_lu v ("I PC, 1 n_ State r' 4
Zip t=i' „ Telephone « CT 2 I?L
ARCHITECT/DESIGNER'S NAME Last
First f �- Lic. No.
Arch itect/Designers Address
Architect/Designer's E-mail Address
City State I
Zip F Telephoned
ENGINEER'S NAME Last I
First L_ e Lic No.F__-_� , .1 -/
G
Engineer's Address
Engineers E-mail Address
City State Ft
Zip c{ ^_{,,--,.� Telephone 1-i 11 i
CONTRACTOR'S NAME/COMPANY
Lic No. Class
Contractor's Address
Contractor's E-mail Address
V V1 ' +j�
^
City: t.,n. State
Zip 1 ? i; } ^; Telephone
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SETBACKS REAR SETBACKS FRONT
PERMIT NO. I1P ;S .?! 0
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. R24�2
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $