HomeMy WebLinkAboutPV2023-0314 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application ��E"'°Rre
[ Comm'I r Residential City of Newport Beach -Building Division T
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL ° .ow^''
[Building ['Grading j-Drainage r/Elec (-Mech
[Plum Cu vd Cut F_Cu vd Fill F_
Project Address (Not mailing address) F_
r Fire r Liq r Landslide rN/A Floor Suite No
2.3Z` ACI� o_
F_ F_
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Description of Work
Use Conrt Type
MovN SoCArc.
12(G4J
# StoriesF # Units (if Res)
_
Valuation $
7 UW
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--
New/Add SF Remodel SFF— Garage/New/Add
Material/Labor
OWNER'S NAME Last c) C A, V ND
First B q S
Owner's Address
Owner's E-mail Address
232.E fA( r I Dr2
City Coe c)f,L AIR r State �/\
u
Zip I Z 6 L j TelephoneF—
APPLICANT'S NAME Last I AA1 n `� rG�
!, K-
First
Applicant's Address
Applicant's E-mail Address
/<'Z,79 0_5 N 01? IP)j 6C Vb A
SP V41'Je �_1/�JZb ✓')t F, nib/
City � /� /. f, f t}J� State
Zip J'� �' Telephone �,- q 1 Z--DV6 9
ARCHITECT/DESIGNER'S/NAME Last First— Lic. No. F_
Architect/Designer's Address
Architect/Designer's E-mail Address
City I State F_
Zip F_ Telephoned
ENGINEER'S NAME Last �
First F_ Lic. No.[—
Engineer's Address
Engineer's E-mail Address
City � State F_
Zip F__ Telephoned
CONTRACTOR'S NAME/COMPANY F'�e6 � n I
Y
S� �, pj Lic. No. 85 ZS� �' Class C' tS�
Contractor's Address
Contra/c`tor's E-mail Address
/2-7 �^L /M/>w r(12�) -7-1
I'� �J�,.N � � ���,t�.'� Sri �CI� N2:
City l�S �� /y,/!��/O State F
ZZip /3, �� Telephone[
SETBACKS REAR SETBACKS FRONT PERMIT NO.����
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $