HomeMy WebLinkAboutXR2023-0851 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit (QQJpjplication of?�`� a
r Comm'I F_ Residential City of Newport Beach - Building Division iCIF—W�� I
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F_ Building FGrading FDrainage rElec rMech rPlum CuYdCut F CuYdFill F
Project Address (Not mailing
address) I— Flood r Fire F_ Liq r Landslide FN/A Floor Suite No
1�0� sUsS�x
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Description of Work
Use F ConstType F
1
# Stories #Units (if Res)
I
Valuation
New/Add SF F_Remodel SFF-Gara e/New/Add
g
$ -3 ) 00 O
Material/Labor
OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
1307 SLASSek
City I New porgy- sc A n
State (; A ZipFT;, G40 TelephoneF—
APPLICANT'S NAME Last
lC, I � , yl s First "J nSJ
Applicant's Address
Applicant's E-mail Address
a� 132 S-1-tn}� ��
Jc�l�i,vj�vv(Canever xlar-co
"
City cep � $
State C � Zip c, c -D Telephone
ARCHITECT/DESIGNER'S NAME
Last First �— Lic. No. F
Architect/Designer's Address
Architect/Designers E-mail Address
City
State F Zip F TelephoneF
ENGINEER'S NAME Last
First Lic. No.F
Engineer's Address
Engineer's E-mail Address
City
State F_ Zip I Telephone
CONTRACTOR'S NAME/COMPANY
Uv-bav� LSO�Cti'� Lic No. RP Is Class ,(`
J
Contractor's Address
Contractors E-mail Address
City
State F--Zip F_ Telephoned
�c IgZ62'�—O$S
SETBACKS REAR
SETBACKS FRONT PERMIT Napwmm 612
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
/q� L
DEVELOPMENT NO 7 PLAN CHECK FEES $