HomeMy WebLinkAboutXR2023-2710 - Permit Application..�trccc rvr k OMDCI Uuilding & Solar Permit Application � Poq>
Comm'1 F-- Residential City of Newport Beach - Building Division °� a-,
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building ro - g r Grading (—Drainage r Elec � Mech Plum j�--
Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F lood F- Fire j _ Liq F- Landslide [_N/A Floor
Suite No
2 i �5 5 � ih- _+ter, _$) _�a_t:._tSe ___ rt-Bec C 9zrx3 No
Description of Work
71-
t�41 Use F ConstType F_
16 -. #Stories # IV ij f Be
New/Add SF _ Remodel SF 2 _ — Garage/New/Add Valuation $
Material/Labor,
OWNER'S NAME
Lastb,r First e �.-
Owner's Address -
Owner's E-mail Address
2195 _ .hes-in _n� Gr-ber
City ab_k X- - Co
_ -NN, �- --- -
Q(S-( _¢((Ck State f l.�
------- Zip % TelephoneRRT 21 �d _ ^ /
APPLICANT'S NAME Last ! T(�
First_._ I1V`1
Applicant's Address ------ - -
Z Z { Applicant's E-mail Address
- r%vt e �
City Ltd dv1. _ G roves state --- T1r� a Prev� 41 feSiTiCQ e
e� --
Zip Telephone( %{ �.d +T _ -7g� Z
ARCHITECT/DESIGNER'S NAME L ( 1
Last First �— Lic. No. �—
ArchitecUDesigner's Address - -
Architect/Designer's E-mail Address
City _
- - — State
Zip l— Telephoned---
ENGINEER'SNAME Last
First r - Lic. No.f
ngineer's Address -
Engineer's E-mail Address
city F� - — State Zip �— Telephoned
CONTRACTOR'S NAME/COMPANY n q
_I`e_St0(_Qf/Cb:� Lic. No. g��/�Class�
Contractor's Address U
2 7- 1 Or q ri C wo�ve Contractor's E-mail Address
city II Q- - � �vr'f i C%A • Ott
af-JIg () '� �� k./� State Zip �Z o I Telephone®a
LSSETBACKS
TBACKS REAR SETBACKS FRONT
PERMIT N0.yrj2�
LEFT SETBACKS RIGHT 'k
PLAN CHECK NO.
E ZONE DEVELOPMENT NO
PLAN CHECK FEES $