HomeMy WebLinkAboutXR2023-0803 - Permit ApplicationPrint Form Worksheet foG�o,(7�bo Building & Solar Permit Application
F_ Comm'] F- Residential W, 02 3 ty f Newport Beach - Building Division g
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
( Building F_ Grading F`Drainage r Elec F_Mech
F Plum cuYdCut F cuYdFill F
Project Address (Not mailing address) F_ Flood r Fire F- Liq (" Landslide FN/A Floor Suite No
`1lJ _._V,e\ u Zo �
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Description of Work
Use s Const Type F_
.Mo �l CYO
# Stories # Units (if Res)s
Valuation $
U Material/Labor ��J �D
New/Add SFF— Remodel SF1_ Garage/New/Add F
OWNER'S NAME Last First J �-\ IP
Owner's Address
Owner's E-mail Address
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5. l3 ����f ,%• fir'
City State Z7
Zip �%/// Telephone62,G6'(�;
APPLICANT'S NAME Last L �-r
First
Applicant's Address
Applicant's E-mail Address
City State F_
Zip F— Telephoner
ARCHITECT/DESIGNER'S NAME Last
First F_ �--
Lic. No.
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
City State �—
Zip F Telephone —
ENGINEER'S NAME Last
First Lic No.f
Engineer's Address
Engineers E-mail Address
City � State F®
Zip Telephoner
CONTRACTOR'S NAMEICOMPANY r / _ - �, Lic. No. , � I Class C�
Contractor's Address
Contractor's E-mail Address
City / � State �
Y
Zip tT� J/
/ �aa 3 Telephone
SETBACKS REAR SETBACKS FRONT
PERMIT NO. �20t.30 080 '3
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. f t eta- 019L
USE ZONE DEVELOPMENT NO \ �"�Lt•QT1.S PLAN CHECK FEES $