HomeMy WebLinkAboutXR2023-0743 - Permit ApplicationPrint Form Wof'ksheat for Combo Building & Solar Permit Application N °a.
Comm]Residential City of Newport Beach -Building Division �)
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
-Building [Grading f—Drainage [Elec F_Mech (=Plum Cu Yd Cut Cu Yd Fills
Project Address (Not mailing address) C Flood F_ Fire F_ Liq (— Landslide F_N/A Floor Suite No
-lqs s�T ►�uut =,cz,� C4Ce,t -- F �-
Description of Work Use F_ Const Type sT w
� a _
# Stories # Units (if Res)s-
New/Add SF Remodel SF Garage/New/Add--- Material/Labor ��/r��l�a
OWNER'S NAME Last First
Owner's Address Owner's E-mail Address
City � ( t.9NQ672'r _ �EYY ¢}- - State F� Zip ! 0 O Telephone 1 4F 7 (01 Lo -
._
APPLICANT'S NAME Last tL_ First)
Applicants Address Applicant's E-mail Address
136) SVL-
city I State --! Zip � TelephoneF—
ARCHITECT/DESIGNER'S NAME Last_ ��
First Lic. No. �—
Architect/Designer's Address Architect/Designer's E-mail Address
v Ct I mil - - CA�LfI l kM�i}11iLr _
City SI Tic} U� --- State f vr, Zip t l)'1 ��5 Telephone Ei -73,S-- 6
ENGINEER'S NAME Last First Lic. Nos —
Engineer's Address Engineer's E-mail Address
-
City State sm Zip �— Telephone[ ---
CONTRACTOR'S NAME/COMPANY w`.i L'c. No. Class
�s-f�ern
Contractor's Address Contractor's E-mail Address
- -
i city State �— Zip � Telephones_
SETBACKS REAR SETBACKS FRONT PERMIT NO. %,�'►4 3— p7y3
SETBACKS LEFT SETBACKS RIGHT p PLAN CHECK NO.FCZOZ3- 061y
USE ZONE DEVELOPMENT NO PRIM-0108 PLAN CHECK FEES $