HomeMy WebLinkAboutXR2023-2094 - Permit ApplicationPrint Form IWorksheet for Combo Building & Solar Permit Application
r Comm'I j/ Residential City of Newport Beach - Building Division
NOTE PLAN CHECK FEES DUE AT TIME OF SUBMlrrni
I —Building F Grading F-•Drainage r' Elec
Address (Not
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F Mech r- Plum
Cu Yd Cut Cu Yd Pill
F Flood F Fire F Licl r- Landslide
New/Add SFF — RemodelSFF�
Garage/New/Add �—
OWNER'S NAME
Last
Owner's Address
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city C641� 90` r t4a-
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Owner's E-mail Address
r"N/A Floor
Suite Nc
Use -r, ConstType F_
# StoriesFT # Units (if Res)F
Valuation $
Material/Labor FzTa
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State F�W— zip Fq_K;-Z —
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Telephone ci4�-_7uG_ f Er:u
nrruLHIV I'D NAME
Last 1'
l� First Fw�rt� Applicant's Address
, ^ Applicant's E-mail Address
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City
State �—
�—
ARCHITECT/DESIGNER'S NAME ziIc Telephoner
Last S<—
First G R�—
Architect/Designer's Address Lic. No. �—
Architect/Designer's E-mail Address
City
State F� Zip Telephone F_�
ENGINEER'S NAME Last
First Lic.
Engineer's Address
Engineer's E-mail Address
City
State F` Zip F Telephone�—
"" I mm%- I UH b NAME/COMPANY
Contractor's Address icNo. o5S1V, Class FF—
Sbiz urtcr /� a ^47
Contractor's E-mail Address
City State jr—��q--
zip �T_fS Telephone
SETBACKS REAR
SETBACKS FRONT
PERMIT NO. j y 4w_ �z_o_
PLAN CHECK NO. ,G'�V7r
SETBACKS LEFT
USE ZONE
SETBACKS RIGHT
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