HomeMy WebLinkAboutXR2023-2713 - Permit ApplicationPant Form Worksheet for Combo Building & Solar Permit Application /o///��°q>o
Comm'I F_ Residential City of Newport Beach - Building Division rjb
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL o...-t.,
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Building [Grading rDrainageElec rZood
Project Address (Not mailing address) 5 j- Fire r Liq r- Landslide rN/A Floor Suite No
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Description of Work
Use F—Const Type
# Stories # Units (if Res) 83
Valuation $
Material/Labor . Q�
New/Add SFF-- Remodel SFl---$Z-- Garage/New/Add
OWNER'S NAME Last kr bey First
Owner's Address Owner's E-mail Address
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City .. Ive -- irt !Peq C l` State Cf Zip Telephonedrol vs�
APPLICANT'S NAME Last j�jQ�f2� First W�
Applicant's Address Applicant's E-mail Address
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City State Zip 1 Telephone '1 I L�'")-1-7OS,-,
ARCHITECT/DESIGNER'S NAME Last First F F-
-- - - Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State Zip Telephone[ ---
ENGINEER'S NAME Last First Lic. No.F—
Engineers Address Engineer's E-mail Address
City State F— Zip F. TelephoneF7--7
CONTRACTOR'S NAME/COMPANY �� -e t�� Lic. No. ��9�j Class
S�Svia 1 Res - -
Contractor's Address Contractor's E-mail Address
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City Grdpt+ rOLAR, State Zip 161 ZFy Telephone/)-f.7-3-7 -loge
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SETBACKS REAR SETBACKS FRONT PERMIT NO. 'n '/ •Z.11�j
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.