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HomeMy WebLinkAboutXR2023-0782 - Permit Application (3)�PrintForm Worksheet for Combo Building & Solar Permit Application F- Comm'I r- Residential City of Newport Beach - Building Division 6 s NOTE: PLAN CHECK FEES DUE ATTIME OF SUBMITTAL [- uilding [ Grading j-Drainage [Elec F-Mech F- lum Cu Yd Cut Cu Yd Fill F Project Address (Not mailing address) C Flood r Fire F_ Liq F_ Landslide F_N/A Floor Suite No '1808 9tvefL Ave- _NeU_Po,�T_ ijel_-6A cfZ663 F Description of Work Use ConstType (� F'co2 ($Kri-I Sµowe27u3 Td�NtoDr9L _ # Stories # Units (if Res)F_ Valuation $ Material/Labor r New/Add SF F_Remodel SFF Garage/New/Add Ir OWNER'S NAME Last RPhLCtS%UM First G' C0'ZG E -- - Owner's Address Owner's E-mail Address City FZ:ew-r (3eACt4 State [TA Zip c, 2603 Telephone 409 - APPLICANT'S NAME Last �k¢gASAt First CaNDy Applicant's Address Applicant's E-mail Address SSfS C- c,A ?A AA, hvL- t1_7So CLAU-t3A:3ALe (Le,3(92n1CA&A (e75 •GU NI City An1'°r_H_ ,1-1 _ _ _ -- State CJ� Zip `j ZBv 1 Telephone 7ly _ 6 51 I? Z-! ARCHITECT/DESIGNER'S NAME Last First F — Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address City State Zip F Telephone— _.- -_ - _- ENGINEER'S NAME Last First F_ Lic. No. Engineer's Address Engineer's E-mail Address City �— State �— Zip F Telephoned CONTRACTOR'S NAME/COMPANY Lic. No. �— Class F_ Contractor's Address Contractor's E-mail Address City �— State F Zip F Telephoned® SETBACKS REAR SETBACKS FRONT PERMIT NO. WZ� 0182 SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $