HomeMy WebLinkAboutXR2023-1780 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application ,,EWpgR,
r Comm'I � Residential City of Newport Beach -Building Division
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NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding r Grading rDrainage r Elec r Mech r Plum CuYdCut F CuYdFill F
Project Address (Not mailing address) f Flood r Fire r Liq r Landslide rN/A Floor Suite No
Description of Work
Use F—Const Type
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# StoriesF_ # Units (if Res)F—
Valuation n C0
bor `(7
Material/Labor
New/AddSF� Remodel SF�
Garage/New/Add—
OWNER'S NAME Last j I 1 1 I
1
First el (� /
Owner's Address
Owner's E-mail Address
City State / / (L/'
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Zip CMG Telephone / i y7
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APPLICANT'S NAME Last Lf - I l First j o r-/
1
Applicant's Address
Applicant's E-mail Address
City
V (<�(�`rCC, State LI(�
Zip Telephone
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ARCHITECT/DESIGNER'S NAME Last �—
First Lic. No. �-
Architect/Designer's Address
ArchitecUDesigner's E-mail Address
City I State F_
Zip F_ Telephoned
ENGINEER'S NAME Last �
First F_ Lic. No.F_
Engineer's Address
Engineer's E-mail Address
City �- State F_
Zip F Telephoned
CONTRACTOR'S NAME/COMPANY Il / l t / `
4 1 1 bl
�1 / 1_ �G L,1 Lic No. (� 1 1 %ssF
iC'ontractor's
Contractors Address
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E-mail Address
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t- P m—bovici DAB L=C:,)n - 1
City I 1 ^ � �� Y State
1
Zip (�z Telephone q4 �� � �9K
-12 20
SETBACKS REAR SETBACKS FRONT
PERMIT NO. �ftZ3
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. F 2023'1!570
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $