HomeMy WebLinkAboutPV2023-0059 - Permit ApplicationL. Print Form Worksheet for Combo Building & Solar Permit Application
(— Comm'[ 1-Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
r- uilding r- Grading- F-Drainage (— lec r Mech
r Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) f Flood
r Fire r• Liq r• Landslide rN/A Floor Suite No
4Da Nehi.f, NLw. Dy`t LaLh
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Description of Work
Uses ConstType F
ay, ro
I V LV
ti Stories It Units (if Res)s
Valuation $ \\,,
Material/Labor FGJ
New/AddSFF— Remodel SF�- Garage/New/Adds—
OWNER'S NAME Last
First O 1,es
Owner's Address
Owner's E-mail Address
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warren Janah sI goo cOrvv
City FW_ State s�
Zip FqR Telephone 9. W . SW
APPLICANT'S NAME Last
First futI1VLI/i
Applicant's Address
Applicant's E-mail Address
b Cahn DS Cv
Iih� E0 6016 - cb nA
City �/��� State l �✓�-
ZipP1 1�� Telephone
ARCHITECT/DESIGNER'S NAME Last �—
First F Lic. No. F_
ArchitecUDesigner's Address
Architect/Designees E-mail Address
City Stale F_—
Zip F_—Telephone
ENGINEER'S NAME Last WYSSLING
First F SCOTT Lic.No. 83664
Engineer's Address
Engineer's E-mail Address
City State F
Zip r Telephoned
CONTRACTOR'S NAME/COMPANY R))� (Tla`/
11V •]�
Licto No. N -Class C; �,0
e u
Contractor's Address
Contractors E-mail Address
I -K)t�
City , State I
Zip Telephone a,
SETBACKS REAR SETBACKS FRONT
PERMIT NO. PV2023-0059
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. PC2023-0253
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $