HomeMy WebLinkAboutXR2023-1404 - Permit ApplicationPrint Form j Worksheet for Combo Building & Solar Permit Application
r Comm'I Fv- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Building r Grading j-Drainage I-/Elec r Mech
r Plum Cu Yd cut l F_ Cu Yd Fill j_
Project Address (Not address) F Flood
r Fire r Liq r Landslide rN/A Floor Suite No
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Description of Work
Use .56.-1 ConstType F✓g
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# Stories #Units (if Res)
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T1n,i1 (2, s�i�C �3 Ci).j�a��C [
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6—) tJ
42 Cc 4+i 11 ( N
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New/Add SF 31 36 Remodel SF Garage/New/Add
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Valuation abor Z8 i
Material/Labor /
OWNER'S NAME Last
First 7< ��
Owner's Address
Owner's E-mail Address
7r Yso,lp.-r
City State �—
Zip 2d 2659, Telephoner;/0 - 6/4 /d7`I
APPLICANT'S NAME Last <� ���
First I lcfr/ff `< /
Applicant's Address
Applicant's E-mai r(ddress
/28d1 If�e�i J�, JXr ?07
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City G t�� State ;q Zip
y76,./ / Telepho 9f/-Y7Y-Zi7
ARCHITECT/DESIGNER'S NAME Last
First F_
Lic. No.
Architect/Designers Address
Architect/Designer's E-mail Address
City {� State Zip y r TelephoneF
ENGINEER'S NAME Last %2o.f<p,•q /[
/
First Del { Lic. No.
Engineer's Address
Engineer's E-mail Address
Zo ZT O .! .. 4-. J/e. S
City j7� •�% State zip Telephone 9'yq-36f-11-r
TSI 678
CONTRACTOR'S NAME/COMPANY
Lic. No. 5966 Classl t
Contractor's Address
Contractor's E-mail Address
J rC•''
City OY.� State ;A Zip qlPd/;r Telephone 7/y -,z,a/_Zyoa
SETBACKS REAR SETBACKS FRONT
PERMIT NO.>C ta23-slyo
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. PC ZOZ' 127
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $