HomeMy WebLinkAboutXC2023-0086 - Permit ApplicationPrint Form Worksbeet'for Combo Building & Solar Permit A licatiort
40 Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITT
Building [Grading Drainage )OElec ;511A h 11 u Cu vd Cut Cu vd rill
Project Address (Not mailing address) C Flood F_ Fire f Liq E_ Landslide CN/A Floor Suite No
Description of Work Use
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l( \� # Stories # Units (if Res)F
Valuation $
New/Add SF Remodel SF (V _ Garage/New/Add F — Material/Labor l/
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OWNER'SNAME Lastl M� 7I f `��(� First��
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Owner's Address Owner's E-mail Address
City � �el ar - State EJ t � 2lj Telephone
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APPLICANT'S NAME Lastl Hi�AAt4pcZ
Applicant's ddress
City �_Q '/'�� --- - State
First
Applicant's E-mail Address
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Zip (�DO Telephone1_°!Z�
ARCHITECT/DESIGNER'S NAME Last —� First (`'�Ja6r-k,1 LIC. No.
Architect/Designer's Address
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City C(.IT-zr-- State �—
ENGINEER'S NAME Last
Engineer's Address
Architect/Designer's E-mail Address
Zip q�7�Z Telephone 3tn_277,-7&57
First Lic. No.
Engineer's E-mail Address
City State F Zip f — Telephone
CONTRACTOR'S NAME/COMPANY � 2 2 Lic No. W736'75 Class
Contractor's Address
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City k. & State � A
Contractor's E-mail Address
Arl4eP 'aMe1'G_� - +a (. Cora
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Zip ke �6 Telephone 7,s 6/ 6Z5(,
SETBACKS REAR SETBACKS FRONT PERMIT NO. I- zL`S' — U
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $