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HomeMy WebLinkAboutXR2023-1733 - Permit Application—/Print Form_ Worksheet for Combo Building & Solar Permit Application oQ� IV `omm'I Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIMF nF Sl IRKAITTAI wilding Grading F-Drainage r Elec r Mech r' Plum CurdCut F_ CurdFill F_ Project A dress (Not mailing address) F Flood r- Fire r Liq r Landslide I —N/A Floor Suite No Description of Work 6UA LDS Zf n o,� Use z-ConstType r/-f1 _ /' y�� x # StoriesFT # Units (if Res)j / n /4' - �lQi,� ,h /`/T/ ��' �L I n E �iL jL C F i G, . i4S f 4-1112,* wow j J 6,Aa . Valuation $ Material/Labor `GQi'Tl� r New/Add SFF— SF 71 SF Garage/New/Add �— OWNER'S NAME Last First Owner's Address Owner's E-mail Addres City late Zip F_ Telephoned APPLICANT'S NAME Last 7��G:q>e First );i1� Applicant's Address Applicant's E-mail Address /fib At /16' i_�_ City�A jS L eA G- AA,,D State �ja ZipF? Z Telephone / / � ARCHITECT/DESIGNER'S NAME Last GAA/ z. First ,9 f �f / � � — Lic.N -Z�22r� Architect/Designer's Address Architect/Designees E-mail Address City Zip TelephoneF— ENGINEER'S NAME Last First Lic. No.r— Engineer's Address Engineers E-mail Address City State �— Zip �— TelephoneF— CONTRACTOR'S NAME/COMPANY !J Lic. No. %of ?76 Class L� Contractor's Address Contractor's E-mail Address / G �-(� //di I City State �— Zip TelephoneF SETBACKS REAR SETBACKS FRONT PERMIT NO. 12ZflL-5 - II "1,1 SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $