HomeMy WebLinkAboutXR2023-2079 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F_ Comm] r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building r Grading r-Drainage r Elec r Mech
r- Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood
r- Fire F_ Liq F_ Landslide rN/A Floor Suite No
207 o/eA-NG E 0. - Al Z5.
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Description of Work
Use Wi Const Type v B
iPEPff/2 �h`�2 P�f/r/ �EftK
Gip. aD
# Stories # Units (if Res)
BCLt)W
Valuation
Material/Labor
New/Add SF Remodel SF Gara
Nc
e/New/Add F_
g
OWNER'S NAME Last
First
Owners Address
Owner's E-mail Address
City State
Zip F_ Telephoned
APPLICANT'S NAME Last DG,4141)S� First /%/ems
Applicant's Address
Applicant's E-mail Address
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edslextv'eine.cory
City / ��/2��G-' '',L/ State F
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Zip �jI Telephone 9Lf. Z�CSQ
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ARCHITECT/DESIGNER'S NAME Last Lic. No.
First e-428 t
Architect/Designers Address
yy�� ,,ccam�
/)Ivt tLBAsigrier's E-mail Address
City F State F_
Zip [_ Telephoned
ENGINEER'S NAME Last
First �� Lic. No f
Engineer's Address NOME /C�� ID
Engineers E-mail Address
City State F—
Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY B�9Clas
//�e
Contractor's Address
Contractor's E-mail Address
3¢� N#6414� s,
era CM&YO
City 1 005/ q r;�GS4 State I e
Zip ��p2� Telephone F� g �>47_3
/_ -_ - 2-
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHEC O.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $