HomeMy WebLinkAboutM2023-0045 - Permit ApplicationPrint Form - Worksheet for Combo Building & Solar Permit Application
r Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building Grading j—Drainage F_ Elec r Mech
F Plum Cu vd Cut Cu Vd Fill F
Project Address (Not mailing address) F_ (" Fire F Liq F_ Landslide rN/A Floor Suite No
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Description of Work
Use ConstType
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# Stories # Units (if Res)F
((77
New/Add SF1 Remodel SFF--_ .' — Garage/New/Add F�
Valuation S
Material/Labor i SC) r C O 0
OWNER'$ NAME Last f I c5 i\
Owner's Address
First /h �� r
1
Owner's E-mail Address
r. I
�l L L/ ty, iJ eft i_ r P��.
t-t ! Q
City / State �j
KL-a_.�'71,^ f �j�_ctiCl'1 I �-`("i
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Zip , Telephone qc4 4;33._5 3v
APPLICANT'S NAME Last (\� t ��� i
First L14�o%
Applicant's Address
Applicant's E-mail Address
83 � ( -) +-k S-i-
city —Cf T ft State I C,
Zip �t Z� Telephone
ARCHITECT/DESIGNER'S NAME Last FirstF Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City F State I——
Zip Telephoner.--.--
ENGINEER'S NAME Last , . /
c-+ [
First � �� Lic. No. 44
Engineers Address
Engineer's E-mail Address
( (G'` co-5c i-e�, c i Y
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City L.tsi 1`-'-�f- State
Zip C.3-� Telephone�>
CONTRACTOR'S NAME/COMPANY
�, 1
Lic. No. I Class
iW
7�Contractor's Address t
Contractor's E-mail Address
City 7 State I-----_—
Zip �-- Telephone
;ETBACKSREAR SETBACKS FRONT
PERMIT NO. MZOZ3-OOt4
TBACKS LEFT SETBACKS RIGHT
PLAN CHECK No. PC 2023- I 37
?ONE DEVELOPMENT NO
PLAN CHECK FEES $