HomeMy WebLinkAboutXR2023-0317 - Permit ApplicationvrinE ry m vvorKsneet Tor combo Building & Solar Permit Application
F_ Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME C)F SI IRMITTAI
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Project Address (Not mailing address) F7 Flood r- Fire F_ Liq j- Landslide FN/A Floor Suite No
Description of Work 2� ��
Use F- ConstType
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# Stories # Units (if Res)s-
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New/Add SF�— Remodel SF�—
Valuation$ /
Garage/New/Add Material/Labor wt7
OWNER'S NAME Last c
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First
Owner's Address
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Owner's E-mail Address
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City State F—_ Zip F — Telephone
APPLICANT'S NAME Last )�G1tr First
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Applicant's Address
Applicant's E-mail Address
City ADSMQ SitACAnt OVA State �—
Zip Telephone GG/_ (� �7 .ZJ%Ci
ARCHITECT/DESIGNER'S NAME Last First
Lic. No
Architect/Designer's Address
Architect/Designer's E-mail Address
City State F
Zip F------ Telephoned
ENGINEER'S NAME Last
First s® Lic. Nos --
Engineer's Address
Engineer's E-mail Address
City State ��
Zip I Telephoner
CONTRACTOR'S NAME/COMPANY
Lic. No. �i 76 Class
7i�/T-Tl. l3
Contractor's Address
Contractor's E-mail Address
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City F MIQW__0e7 __Qe State—
Zip r- Telephones�Q
SETBACKS REAR SETBACKS FRONT
PERMIT NO. 4U 1r • Oil
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $