HomeMy WebLinkAboutXR2023-1981 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application Q
r Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding r Grading F-Drainage r Elec r Mech
r- Plum CuvdCut CuYdFill
Project Address (Not mailing address) r Flood
r- Fire r Liq r Landslide r-N/A Floor Suite No
--7
Description of Workf (P H
Use F_ Const Type
h S� CG G(L� -
J
CI S U`' ��
# StoriesF_ # Units (if Res)F_
P'�CAA . CJGL_,� tq\Z. �Or /uc&o 66P E
Frc% +.
SF Remodel SFGarage/New/AddF—
Valuation $ F/D /VNew/Add
Material/Labor
OWNER'S NAME Last '� U„Z�1 t c-,
First Vkw_u l�
Owner's Address
Owner's E-mail Address
I/-- COV-\\e-e
City I A)"vc� State F'(ft'
Zip &o Z` Telephone[
APPLICANT'S NAME Last 'i>(J(�CCis C
J
First I
Y
Applicant's Address
Applicant's E-mail Address
WD i6'0)6739��a
City ,1UCwrU,4- [A-(..� State _'J
Zip q 0 Telephone 79>-97s—iy3 /
ARCHITECT/DESIGNER'S NAME Last � f't'�. C, C First RTY �, Lic No. gp((79
l
Architect/Designer's Address
Architect/Designer's E-mail Address
City ND State F}
Zip i✓SX Telephone
ENGINEER'S NAME Last
First 7— Lic. No.r
Engineer's Address
Engineer's E-mail Address
City State I
Zip r— Telephoned
CONTRACTOR'S NAME/COMPANY
Lic N /� /} �-, Class
Contractor's Address
Contractor's E-mail Address
City State F—
Zip F_ Telephoned
SETBACKS REAR SETBACKS FRONT
PERMIT NO. �AYG%/�%/�• (� I
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK N-011l,'PG'Lb Z,,�, • I 1 4,7_/
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $