HomeMy WebLinkAboutXR2023-1270 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application 01W
F_Comm'I F_ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[-Building F- Grading [—Drainage j—Elec F—Mech [- Plum Cu Yd Cut Cu Yd Fill F
Project Address (Not mailing address) [- Flood [- Fire [- Liq [- Landslide [-N/A Floor Suite No
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Description of Work ��
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use F—ConstType
# Stories # Units (if Res)[ —
Valuation r f'/Q V V
Material/Labor
bor , V
New/Add SF f — Remodel SF---.-- Garage/New/Add f --'—_—
OWNER'S NAME Last /j') l C L First CLl FF—
Owner's Address Owner's E-mail Address
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City wQ f/` 1v�/`! State I Zip Telephone
APPLICANT'S NAME Last First
[-Applicant's Address Applicant's E-mail Address
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City � State r--.—--
Zip r Telephone,�—
ARCHITECT/DESIGNER'S NAME Last � �yv First Lic. No. z��
Td A /
Architect/Designer's Address Architect/Designer's E-mail Address
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City N. / (A State F Zip '7�L;7,!05 Telephone 7r [� 73a- � 7,
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ENGINEER'S NAME Last First Lic. No.s
Engineer's Address Engineer's E-mail Address
City � State F_ Zip F Telephoned
CONTRACTOR'S NAME/COMPANY Lic No. 'Me6 I 0 Class
Contractor's Address Con{t/[-actor's E-mail Address C.
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City I ��W � `Z`C\� State C4 Zip j2(�(�U Telephone ���C( Yj3 3�r0
SETBACKS REAR SETBACKS FRONT PERMIT NO. )(,OZ3 - 1170
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK N0. CZVL3 - I' 26
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $