HomeMy WebLinkAboutXR2023-2362 - Permit ApplicationPrint Form_ Worksheet for Combo Building & Solar Permit Application o��0.'° e � 9 pp
r Comm'I XResidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL G<,Foa.
Building r Grading rDrainage r Elec r—Mech
r Plum Cu Yd Cuts Cu Yd Fill F
Project Address (Not retailing address) r Flood
r Fire r Liq r L de r N/A Floor Suite No
i
/� 0/VCff VC
Description of Work
Use s ConstType I
# Storiesr— # Units (if Res)r—
G<{FSiffJ+nGY' IG JrL%� LEA-/l�C� I /y✓A-i�-D �f(-1L
New/Add SFr— Remodel SF /ZO Garage/New/Add
F__
Valuation $
Material/Labor J? �% vC_� v
OWNER'S NAME Last fi/1
First I P40,Q
Owner's Address
Owner's E-mail Address
'SD/ i :'�Jvc�iF./�
�l-�LJJFE Ar, I=CSc3c'.-C7��+.�./+-[�.,�1�T
City r State F_
Zip F— Telephone 71-{ SD 1 [<:!?r
APPLICANT'S NAME Last 4", !rT z-,,%Zs
First P-F-vo Ji
Applicant's Address
Applicant's E-mail Address
City 1 e�05rn InAF6, - State I
Zip 9ZlvZL Telephone 9',li 293 2loS2
ARCHITECT/DESIGNER'S NAME Last I o/Z5t.L_ 4 JA FirstF �� Lic. No. �—
Architect/Designer's Address
Architect/Designer's E-mail Address
BUD .�j�h-r-`r'✓sYt GcvrFl� D�YvE #y011
City j ¢vJ Ji_ State GA
Zip </ Z6 /3 Telephone FITM 93(0 2sZ 0
ENGINEER'S NAME Last
First Fps l y Lic. No. L-9- y/ $
Engineer's Address
Engineer's E-mail Address
City jiz✓�'''E State CrF
Zip yZ�/1& Telephone 745 93G; 2Sav
CONTRACTOR'S NAME/COMPANY Lic. No. i3Jo-7 12-7 Class
Contractor's Address
Contractor's E-mail Address
123C, Lr/.i w.µ7 A i_
A<�
Fh�^�ST,�Nyf-l�nl DG�kl-Tr_� Ur"�. -or,
City 6 Ex57, r /-6a 138 A State F-A
Zip Fj ZG Z c- Telephone g</Gt 2 2 3 ZL-k Z
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $