HomeMy WebLinkAboutXR2023-2825 - Permit ApplicationPrint Form I Workshea't for Combo Building & Solar Permit Application 04 ` �Y e
F- Comm'I j- Residential City of Newport Beach - Building Division oFcr'� 1
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
(-Building F- Grading
(-Drainage r- Elec j-Mech
F_ Plum Cu Yd Cuts Cu Yd Fill s
Project Address (Plot
mailing address) f- Flood
( Fire F- Liq F- Landslide F_N/A Floor Suite No
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Description of Work
Use s Const Type s
# Stories # Units (if Res)s
�L`�� _`-;��tF ��',�i-��-IZ:tI C.i ,n;
New/AddSFF
Remodel SF7— Garage/New/AddF_
Valuation $ �•-� i
Material/Labor r L( �, C LL.
OWNER'S NAME
Last G,0 Per
First
Sohn
Owners Address
`
Owner's E-mail Address
Ciry
State �
Zip F_ Telephoned
APPLICANT'S NAME
-
Last /-ic, L�ia."
First ;t
Applicant's Address `-� L.!
_� �- 4"L' "-,"L}
= `` plicant's E-mail Address
City I
State �
Zip F Telephoned
ARCHITECT/DESIGNER'S NAME
Last
First F— Lic. No.
ArchitecUDesigner s Address
Architect/Designer's E-mail Address
City
State F_
Zip Telephones
ENGINEER'S NAME
Last 004'
First Lic. No. t,
Engineers Address
��
Engineer's E-mail Address I
City
State
Zip Telephone
CONTRACTOR'S NAME/COMPANY
Lic No. ;� 7 Class \�
Contractor's Address
Contractor's E-mail Address
L,
City t.-. u�i i ;�.
-} i< State L- ;-�
Zip j LE- i / Telephone
SETBACKS REAR
SETBACKS FRONT
PERMIT NO. M
SETBACKS LEFT
_ SETBACKS RIGHT
PLAN CHECK NO p-13 7 L
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $