HomeMy WebLinkAboutXR2023-2469 - Permit ApplicationPrint Form 1 Worksheet for Combo Building & Solar Permit Application o4�EWPcRm
rT.,e6mm'I FVresidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
IVBuilding i- Grading rDrainage r Elec r Mech r Plum Cu vd Cut Cu vd Fill
Project Address (Not mailing address) r Flood Fire r Liq r Landslide F_N/A Floor Suite No
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Description of Work 1,41'e7AIL / 1(1-�- j ff
Use �Cl r� Con stType
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Stories w Units if Res) Jam'
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Valuation $ �/ r.^
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New/Add SFF— R�wed�f'SF
Garage/New/Add
Material/Labor j7L�•
OWNER'S NAME Last � First
Owner's Address Owner's - ress
City State �— Zip Telephoned
APPLICANT'S NAME LastFirst �ie1
Applicant's Address Applicant's E-mail Address
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City �Aj6 _94, 7A Zip /SGA-/Vi] State �Z�j�7� Telephone � /-'��'�i)-
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ARCHITECT/DESIGNER'S NAME Last 2,AA1 First � 7/I/D f - 4J_
/ /��Gi / Lic. No. Z 22
Architect/Designer's Address Architect/Designer's E-mail Address
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City State z Telephone
ENGINEER'S NAME Last First Lic. No.r
Engineer's Address Engineer's E-mail Address
City I State F_ Zip F_ Telephone[ —
CONTRACTOR'S NAME/COMPANY Lic. No. F__ Class F_
Contractor's Address Contractor's E-mail Address
City I State F_ Zip F_ Telephoned
SETBACKS REAR SETBACKS FRONT PERMIT NO. %O-Zt)Z%✓
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. �Z T1,- _ 2
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $