HomeMy WebLinkAboutXR2023-2175 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
j- Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building r Grading F-Drainage r Elec r Mech
r Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood
j- Fire r Liq F_ Landslide I -N/A Floor Suite Nc
15-7�- G. dGr7,� guaj) N(wPo/+t� t3i_�wrGA �/ I r
Description of Work
Use F—ConstType
/y�
v
# StoriesF_ If Units (if Res)[—
3•s' So
&,rd
cF
New/Aid SFFRemodel SFF Garage/New/Add
Valuation I ,
Material/Labor O
OWNER'S NAME Last
First 'DAr.J i fyL
Owner's Address
Owner's E-mail Address
IBIS S. t7�JoNsu,tiL �Rav/L
171vS k/aSf++,�wt �GMAIt_, Gil
City ,/ t-'A 4-1?7 State LY
ZIPFe kpg�i Telephone ogpl_�2j'j
APPLICANT'S NAME Last S,M�v
First
Applicant's Address
Applicant's E-mail Address
City State F_
Zip F-- Telephone--
ARCHITECT/DESIGNER'S NAME Last
Lic No.
First F_ I
Architect/Designer's Address
Architect/Designer's E-mail Address
City State F—
Zip � Telephoned
ENGINEER'S NAME Last �
First F Lic. No.F_
Engineer's Address
Engineers E-mail Address
City State F_
Zip F_ Telephone[ —
CONTRACTOR'S NAME/COMPANY N'APl<417ZMf;PA
LicNo. F ClassF
Contractor's Address
Contractor's E-mail Address
City State F_
Zip F_ Telephoned
SETBACKS REAR SETBACKS FRONT
PERMIT NO. X=23 • 7.1'15
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO. ��Q • ZOZ, 1
USE ZONE DEVELOPMENT NO 11 .. ^" ^" ___^ ,