HomeMy WebLinkAboutXR2023-1279 - Permit ApplicationProt'Form I Worksheet for Combo Building & Solar Permit Application (N-0
City of Newport Beach - Building Division
F- Comm'I F_ Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F- Building F_ Grading rDrainage i-Elec r'Mech
F- Plum CuvdCut CuYdFill
Project Address (Not mailing
address) F_ Flood
i- Fire F Liq r Landslide rN/A Floor Suite No
( q U I6C_1�
r3 )
F (
I
VeJ
Description of Work
Use F—Const Type F_
e,ncr�e�`
rya r�
# Stories # Units (if Resf
L
Valuation
MaterilILabor L
4'
New/Add SF RemodelSF�Garage/New/Add
/
OWNER'S NAME Last G C k4 r-?-- C,`
First QZA s t—, "
U
Owner's Address
Owner's E-mail Address
City '�� l� Y t
State C;
Zip Z1'2 Z ( Z Telephone , u
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
City I
State F_
Zip F_ Telephoned
ARCHITECT/DESIGNER'S NAME
Last First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address L
City
State F_
Zip F__ Telephoned
ENGINEER'S NAME Last
First F_ Lic. No.r—
Engineer's Address
Engineer's E-mail Address
City
State F—
Zip �— Telephoned
CONTRACTOR'S NAME/COMPANY
6.lt zN�� Lic. No. F'U`y�RGZGf�CIass�
JJ I , G S �✓ l
Contractors Address
Contractor's E-mail Address
r CZt I _f�—v,v of i Ill— H--I
I i < c, l-a, C,n ,
•�I�ifdc�/
city
State F
Zip Tzzi O Telephone [/�6 04
SETBACKS REAR
SETBACKS FRONT
PERMIT NO IRS''�f� 7 1 -90
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO. N7.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $