HomeMy WebLinkAboutXR2023-0973 - Permit ApplicationPrint For Worksheet for Combo Building & Solar Permit Application o.E�Pogrm
r Comm'I r Residential
City of Newport Beach - Building Division 5i
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F—Building r Grading
rDrainage r Elec (— Mech F— Plum CuYdCut F CuYdFill F_ OeN(
Project Address (Not mailing address) r Flood F- Fire r Liq r Landslide rN/A Floor
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Description of Work
Use F—Const Type F_
# Storiesr— # Units (if Res)r—
F fC1 C E
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Valuation Material/La
abor li (%
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New/Add SFr— Remodel SF f 7Z j
Gara g a/New/AddI F"
OWNER'S NAME
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Last .`� .iy7ncl Yl
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Owner's Address
Owner's E-mail Address
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City I V I
State j "F Zip cj Z , : ) Telephoned
APPLICANT'S NAME
Last (rL
First JQ iyG f
Applicant's Address
Applicant's E-mail Address
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ir /In o _qcc(c.9,/V& Degtrl[I-ki o LC•A,
City S (,, a •, G State I r'Cl P�
Zip / 67 Telephone -4�
ARCHITECT/DESIGNER'S NAME Last �—
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First �V ` % Lic. No ` t Z �{
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Architect/Designees Address
Architect/Designer's E-mail Address
City F T.1 V,?�t �,�, Yin
State �`�
Zip T�Z 9i]� Telephone
ENGINEER'S NAME
Last V`S , C;
First F: I -,.fV -? Lic. No.r —
Engineer's Address
Engineer's E-mail Address
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1-7�
City
State f✓A
Zip It, ' j_5,1_7 Telephone ; , j ? %�- CL
CONTRACTOR'S NAME/COMPANY
'' Lic No. Class
Contractor's Address
Contractor's E-mail-Address
City
State �—
Zip Telephone—
SETBACKS REAR
SETBACKS FRONT
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PERMIT NO. Zot3- 6?97 7
SETBACKS LEFT
SETBACKS RIGHT
/
PLAN CHECK NO. f C Z
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $