HomeMy WebLinkAboutPV2023-0431 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application CNQ
F_ Comm] r Residential City of Newport Beach - Building DivisionNOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding r- Grading
F-Drainage rElec r Mech
r Plum CuydCut CuvdFill
Project Address (Not mailing address) F_ Flood
r- Fire r Liq r Landslide r_N/A Floor Suite No
r---
Description of Work
Use Const Type
1�00 N1 ovth% SoICt Pv i- L,,kktr
E 5 5 TVt54a1(
# Stories #Units (if Res)
\ \rey jc, AC Q�1-Fz'r�
C�6� AC M�nIeS C(J ACpU Com�inN �I✓per
Jer U 2 5 L�J, 13.5K
New/Add SF7—
RemodelSFF— Garage/New/AddF—
Valuation $
Material/Labor 10C)17
1
OWNER'S NAME
Last
First I PAckUrc. \5,00D 6
Owners Address
�i 600 �V
Owners E-mail Address
23 A-, uA5iz�\
Lv,.
e- I even oC Zarc,'rS k en, heel in� • Got'I^
City
State F_
Zip F Telephone 3l(-)— % Oq - q 72t
APPLICANT'S NAME
Last SD3 p
First colt 5
IN
Applicant's Address
Applicant's E-mail Address
J��Ilv,s �WCa,v,etnerc� Solar, �vv✓\
City
State F
Zip TelephoneF—
ARCHITECT/DESIGNER'S NAME Last
First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City I
State F_
Zip _ Telephoned
ENGINEER'S NAME
Last
First Lic. No. _37 i4
Engineer's Address
Engineer's E-mail Address
City
State F
Zip F— Telephone[
CONTRACTOR'S NAME/COMPANY {/1 Y �jrnV\ L ys e\6 V S Ln�� Lic No. C� i 15 Class r -�
Contractor's Address
Contractor's E-mail Address
City
State F
Zip F_Telephone
U
SETBACKS REAR
SETBACKS FRONT
PERMIT NO. PJ ZVZ,7 - CY3
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $