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PV2023-0324 - Permit Application
Print Form I Worksheet for Combo Building & Solar Permit Application 04�E'"�e Comm] F_Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL F_Building r Grading rDrainage r Elec rMech F— Plum CuYdCut F CuvdHIT Project Address (Not mailing address) F_ Flood j— Fire r— Liq r Landslide FN/A Floor Suite No Isla® Lir)CDj�i Lh Description of Work Use F Const Type F 6 wr hS CLl ✓o S # StoriesF_ # Units (if Res)F_ 2D k►N DC, Valuation $ New/Add SF F_ Remodel SF F—Garage/New/Add F— Material/Labor OWNER'S NAME Last �t �� l� �1 First Tvw Vl V� Owner's Address Owner's E-mail Address City ^ yyA 1J RV SA State F9 Zip r�n D Telephone t APPLICANT'S NAME Last t_`�eS ` F'iirst 10(4*' V\ c` Applicant's Address Applicant's E-mail Address °1 aUe., wou0 ewo�r�s wki �w cowl City State ' ` �����TTTT ���` �ar. Zip Telephone ��j `� ?l — �j ARCHITECT/DESIGNER'S NAME Last First Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address City State I Zip F_ Telephoned ENGINEER'S NAME Last First F_ Lic. No.F_ Engineer's Address Engineers E-mail Address City State Zip I Telephone CONTRACTOR'S NAME/COMPANY �n>+;ryI y.Qtno Y 11U' 1 ar Lic No. 61� 3Class � Contractor's Address J1 Contractor's E-mail Address �2 Ie �Ga ewar�s ��� w� s©��.�•c�m City State Zip Z 6T 2 Telephone SETBACKS REAR SETBACKS FRONT PERMIT NO.'y L,�. _ l �•`>.� r-1 SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $