HomeMy WebLinkAboutXR2023-1815 - Permit ApplicationPrint Form J Worksheet for Combo Building & Solar Permit Application
rr%Comm'I rj/Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIMF r)F SI IaMITTAI
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rFXuilding F- Grading r-Drainage rElec F-Mech r Plum Cu Yd CutF_ Cu Yd Fill
Project Address (Not mailing address) F Flood r- Fire r- Liq r Landslide FN/A Floor Suite No
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Description of Work
Use �svConstType I/ A
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# Stories #Units (if Res)F7
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VLGS id�t OJ C/L/A/i, / YF'- ��e,VL'. �iLSc'�. AS �4t�
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Valuation $ p/J
Material/Labor / '
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New/Add SF�— R�eYSF ZpO� t! fe Garage/New/Add �—
OWNER'S NAME Last �� 1/Nlr_ C // First
Owner's Address Owner's E-mail A
City �State F— Zip F_ Telephone[ —
APPLICANT'S NAME Last �4 First F All
Applicant's Address Applicant's E-mail Address
City 1,5At q e A S L A/b State CN Zip Tele hone °
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ARCHITECT/DESIGNER'S NAME Last jL,6.,VPy %L�pl,'il�jZ-/ First LicNoll— -2��2�-
Architect/Designer's Address Architect/Designers E-mail Address
City Zip TelephoneF
ENGINEER'S NAME Last First �— Lic. No.F—
Engineer's Address Engineer's E-mail Address
City State �— Zip F_ TelephoneF_
CONTRACTOR'S NAME/COMPANY In h. h;0/lP k e�a.ry f a fl (� L Lic No. G�S�� II� Class
Contractor's Address Contractor's E-mail Address
City State �— Zip �— Telephoned
SETBACKS REAR SETBACKS FRONT PERMIT NO. X �jj�?/j/ • I B'
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELQPMENT NO PLAN CHECK FEES $