HomeMy WebLinkAboutXR2023-1502 - Permit ApplicationPnnt Form I Worksheet for Combo Building & Solar Permit Application
F Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building r Grading gDraina r Elec r Mech I�
r Plum Cu Yd Cutl � Cu Yd Fill
Project Address (NO r ing address) r Flood r Fire r Liq dslide �N/A Floor Suite No
/v 3 � 5 ,�_,4 L ✓E �� F_-
Description of Work tf UseW- / Const Type y
# StoriesF/ # Units (if Res)F
E j��� Valuation $
New/Add SF 2 Remod SF 2 77Z Garage New/Add I U Material/Labor 3U6, UCH
& 32
OWNER'S NAME Last I L�� VV,4 /k S First ST E V E A/
Owner's Address Owner's E-mail Address
4 N ST6V�tl, t l�t��7ZUT�,gvL, C6pl
City �ujZo�fV State ^
/-F Zip 72L l Telephone iy,,f&6- yss i
APPLICANT'S NAME Last
Applicant's Address
6 3O C-,4rn e0 NL.4Jor L7�
City o r ,4 Att 114 K State I �—
First I 15 j Z, L.
Applicant's E-mail Address
Zip �2 ,4- arj Telephone '7/L/-G1 L/- 70 JS,
ARCHITECT/DESIGNER'S NAME Last tf.h 5 eE }� FirstFib I r' Lic. No. [` 177 /f
ArchitectlDesigner's Address / Architect/Designer's E-mail Address
.5 3C Gyr�Ec' NjCyHL 4�✓/JJ
•D,�' /.��TG/,DL`S/c-/ii CSC � GLUfj,4 L: N�
City r4fG12o,y4 ,,4.e .:,4,- jR State �— Zip 921,5 Telephone 7/Z/_ GLly -76A6
ENGINEER'S NAME Last l 1,-9 I-A4 W U / f''T First l Z, ELVLV+C/ Lic. No. 2 3 53
Engineer's Address
/'/ q u,4 ) L I —7,R6,T STE 2 z/
City 1.4/6- 0,27- I�L YCl i State 3i
Engineer's E-mail Address
Ci 66AlN e-GA/AYlt': C-Om
Zip j &&-- Telephone Jy 73 - Z L106
CONTRACTOR'S NAME/COMPANY C &(,/V t- S CGj S Lic No. 13 YClass
Contractor's Address
City {� G(, �� State e
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
Contractor's E-mail Address
de.rSa�(,� C�nce�ct�+eCl�S', CL'%
Zip -/L(O 2� TelephoneF-V �/� 3fps._`
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEES $