HomeMy WebLinkAboutXR2023-2322 - Permit ApplicationPrint Form �itlZ�012�
1Norksheet for Combo Building
Solar Permit Application
F Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DU
rBuilding
AT TIME OF SUBMITTAL
j Grading j—Drainage F_ Elec F Mech
Project Address (Not maiiin
Description of Work
--cr
New/Add SFF— Remodel SF
Plum Cu Yd Cut F— cu Yd Flu
F Flood r Fire F Liq F Landslide F_ N/A
Floor Suite Nc
Garage/New/Add r —
OWNER'S NAME Last
First
Owner's Address
0O �/ r'/ 1 / / Owner's E-mail Address
/ D✓Z /�1I m,uY
city I /(4WP,,4 De 4 c6,
State ��` Zip 97(P(10 Te
n'vLr6HN i'D NAME Last
Applicant's Address
City
ARCHITECT/DESIGNER'S NAME
Architect/Designer's Address
City
ENGINEER'S NAME Last
Last
First
Applicant's E-mail Address
Use I— Const Type F_
# StoriesF # Units (if Res)[_
Valuation $
Material/Labor F//
9N9. 3 s y 37(,o
State F Zip F� TelephoneF�
First
Architect/Designer's E-mail Address
Lic. No. F�
State �_ Zip F� TelephoneF�
First
Engineer's Address
Engineer's E-mail Address
City State �—
Zip F_ Telephone
Lic.
CONTRACTOR'S NAME/COMPANY /J
�5�0� �� `�j I f�AK Lic. No. "I/)1 D�d Class —
Contractor's Address lC J
/ y , Contractor's E-mail Address
City � /dl/G�14 C�f� Yf4 C,!4'!4C. C oc',
State CI zip �1
/Z%�a3 Telephone 9" / (,G •OSOn
SETBACKS REAR SETBACKS FRONT �^,�
SETBACKS LEFT —�_ PERMIT NO. 'V W� . 23'1/1/
SETBACKS RIGHT PLAN CHECK NO.
USEZONE �J i�?j
- DEVELOPMENT NO „t A&I n^