HomeMy WebLinkAboutXR2023-1275 - Permit ApplicationPrint For Worksheet for Combo Building & Solar Permit Application
r Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building r Grading r-Drainage r Elec F Mech
r Plum curdCut s cuYdFill s
Project Address (Not mailing address) r Flood
r Fire r Liq r Landslide rN/AFloor Suite No
53q U� e4thic,4cr
r
I F-
Description of Work
Use s ConstType s
WoU� i 0 CO V &r
# Stories # Units (if Res)s
Valuation $
--
New/Add SFF Remodel SF F y. t; Garage/New/Add
Material/Labor FJI 2,�zro
OWNER'S NAME Last OV�Ch
First ,CN`o4b
Owner's Address
Owners E-mail Address
s39 11 eIjM(t\$
rc�u�cl�Qtmmr.. Can^
City Net-r ��,k State
Zip Q,3 Telephone �qWL) S11-3oL r,
APPLICANT'S NAME Last Corv5
First err�j
Applicant's Address
Applicant's E-mail Address
381( lq-tA( CL(pinR- Cou
�ern10PIaCav111g4g4 t^,c., (awe
City C a.ra- E-Uve- State (�
Zip ClZ pjt{\ Telephone �7t i ) t(2.3 —$ 5./9
ARCHITECT/DESIGNER'S NAME Last First F Lic. No. F—s
Architect/Designer's Address
Architect/Designer's E-mail Address
City I State F__
Zip F_ Telephones
ENGINEER'S NAME Last
First F_ Lic. Nor —
Engineer's Address
Engineer's E-mail Address
City �- State F—
Zip F_1 Telephoned
CONTRACTOR'S NAME/COMPANY COUP {�S(4(+� Nd5(Gl Lic.No. rp2\0-3S Class Cr2a
Contractor's Address
Contractor's E-mail Address
66 Ilud- Gt f,v fWj
City CLt(Jcl 6Yovc- State Cc�
Zip C(%[ qI Telephone ( 4,,q) -(z3-55?9
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $