HomeMy WebLinkAboutPV2023-0132 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application �EWPoRr
F_ Comm'I F Residential City of Newport Beach - Building Division n , � �
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL f W_ 013k V
Building F Grading F-Drainage (y Elec F_Mech F- Plum Cu Yd Cuts Cu Yd Fill s
(Not Mailing address) C Flood F_ Fire j_ Liq F_ Landslide FN/A Floor Suite No-
Project A//
jdl1dress
Description of Work
Use Const Type s
�HS�ai�aji�� o� 42k �2 3o�w
SSlaa 4he15
# Stories # Units (if Resf
New/Add SFs-- Remodel SFs--
Garage/New/Add F—
Valrialuation $
Mate/Labor
�IObo
_
OWNER'S NAME Last //�� "�
V'uri First G� �✓<�
Owner's Address
Owner's E-mail Address
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City �IY-_¢v� �24c1 State f (+ _
zip g2E6G Telephones—_-
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APPLICANT'SNAME Last din-tr�ev
First I \/ IV},.p_
Applicant's Address
Applicant's E-mail Address
1'f ID
ivi`�O(�224Zc_ Ce`,Le1V1_
City State Ft i
0
�n
Zip z�6S Telephone �k-202-
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ARCHITECT/DESIGNER'S NAME Last First F Lic. No. --
Architect/Designer's Address
Architect/Designer's E-mail Address
City State �—
Zip s— Telephone
ENGINEER'S NAME Last
First F— Lic. Nos --
Engineer's Address
Engineer's E-mail Address
City State F_
Zip Telephone—
CONTRACTOR'SNAME/COMPANY
�n�y �C Lic No. (0(427c Class C/Q
Contractor's Address
Contractor's E-mail Address
lca.� w Gem Ave 40
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City Uoatl2 State CN-
Vv
P 2 � Telephone G - Z�� -
Zip _I 00 P 4( 5 Ur2�
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. r2L. ,� � ,5L
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $