HomeMy WebLinkAboutXR2023-2013 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application pF�E" °gr
r Comm'I jCi Residential City of Newport Beach - Building Division o
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL G
luilding F Grading
rDrainage r-Elec F Mech
r Plum CuYdCut F CuYdRI F
Project Address (Not mailing address) [ Flood r Fire r Liq r Landslide FN/A Floor Suite No
306 6(modlon
Avia, _4vom De
A 4 e",C4 6r1Vas_ F I-_
Description of Work
Use 3 Const Type
u5
drl Yam
WIN W
# Stories # Units (if Res)F_
1
51426 1M Q R (4j
541nie {ixlr/1
Valuation $ �)�New/Add
Material/Labor !/
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SF�— Remodel SF Garage/New/Add I r
OWNER'S NAME
Last IbIr lff? First Waj,64yn
Owners Address
Owner's E-mail Address
305 01amr m
Ne•
,
City CO�(Jhu l/�1 /A State �C�
�✓"1 /11
Zip � Telephone qjr y3-�y46
APPLICANT'S NAME
Last First A111.
Applicant's Address
Applicant's E-mail Address
7Z 3- S}gk Cr/lu
aly . 5v;% T
Ij��J ' ra!2 c%,7 jai` ✓I
City l iZrkl
State I (4
Zip V??/ Telephoneff/y%7FIlii _
ARCHITECT/DESIGNER'S NAME Last �
First Lic. No, gys63
J
Architect/Designer's Address
Architect/Designer's E-mail Address
Em6_a
City
State F_
Zip F— Telephoned
ENGINEER'S NAME
Last
First F Lic No.F--
Engineer's Address
Engineer's E-mail Address
City I
State I
Zip Telephoned
CONTRACTOR'S NAME/COMPANY Arvkge1u,
�_vw Lic. No. 51733 Class
✓
Contractor's Address
Contractor's E-mail Address
-745s s4e 649w
l31✓r% S✓,��
6rc �am6�4,Kzca�r% ja�f.drn
City ��' lW�
State
Zip, Telephone 71 y- C 7/- Y1
SETBACKS REAR
SETBACKS FRONT
�vO
PERMIT NO. V in'S- Vx 7
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK
USE ZONE
DEVELOPMENT NO
`lets.
PLAN CHECK FEES $