HomeMy WebLinkAboutXR2023-1736 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application WPpa
F_ Comm'I Residential City of Newport Beach -Building Division o `M1
` \ NOTE: PLAN CHECK FEES DUE AT TIMF OF 9i IRMiTTAi 5,.__Mlr
F_Buildingr Grading
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(Drainage r Elec r Mech r Plum CuYdCut CuvdFill F
Project Address (Not mailing address) F_ Flood r Fire r Liq I— Landslide F_N/A Floor Suite No
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Description of Work
Use YL Const Type �. �j
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# Stori s # Units (if Res)F_
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Valuati n 5 ao
Maten I/Laoor W/GY?V
New/Add SF
Remodel SF 19— Garage/New/Add
OWNER'S NAME
Last 56 vnev'a V4 First Pot. _
Owner's Address
Owner's E-mail Address
4100 161)(evo tAa
fSavGYztvtiai�t5C iu W.cov�
City qeW of, 6,eiokq State G& Zip pi 3 Telephone 5o3-31-+-284d
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APPLICANT'S NAME
Last coyovic, First t?_,)ewtTO
Applicant's Address
Applicant's E-mail Address
513o t• LCA Pa WLI Ace-, `le- ID-5
City ,��(�
State F& A Zip lI LC�04 Telephone 1(4- �+I_ 1I�
1
ARCHITECT/DESIGNER'S NAME
Last First Lic. No.
Coro �F
Architect/Designer's Address
Architect/Designer's E-mail Address
5130 . La pal mcA
Avis., s{e 203 �c� y�4t � cct t� t�a�,14t
City frl'ltl/VlelYvl
State Is --A Zip F,2904 Telephonea(C�_3�7/_�/�
77Lic
ENGINEER'S NAME
Last ��I2Gtvl {'f First I/p`�q � N/o. Gtj10�50
Engineer's Address
Engineer's E-mail Address
23315 scnra �a Q
5ry r� 5 Plate -
city MVY.j,4
State FE��_ Zip �25�2 TelephoneO/-!50_63��
CONTRACTOR'S NAME/COMPANY Lic. No. F ClassF
Contractor's Address
C r 6r's E-mail Address
City
State Zipl�— Telephone F_
SETBACKS REAR
SETBACKS FRONT PERMIT NO. o?
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $