HomeMy WebLinkAboutXR2023-0762 - Permit ApplicationPrint Solar Permit Application
L_- ==-1 Form Worksheet for Combo Building Pp.
City of Newport Beach -Building Division
Comm'I F_ Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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F-Building FGrading [-Drainage [Elec FMech
FPlum Cu vd cut Cu Yd Fill
Project As9�9a'ess (Risst dteauil9ng address) � Flood
Fire Li Landslide rN/A�
q r Floor Suite No
/026 Sfa__�.4A1� 223�I (U7Q,02 --
Description of Work
Use I (i� ConstTypeFlit?
C(11/��(Z�T(Onl
# Stories # Units (if Res)7
Valuation $F�
New/Add SF 83 Remodel SF-—Garage/New/Add �— Material/Labor V 1
OWNER'S NAME Last GI AAOX!r- First[ J.4M j6
Owner's Address
Owner's E-mail Address
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City WAoN /UV — State CA
Zip Telephone 2�_ • UI��
APPLICANT'S NAME Last i
First �-
Applicants Address
Applicant's E-mail Address
City State F
Zip F— Telephoned
ARCHITECT/DESIGNER'S NAME Last N4
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First r j 1Vl/? Lic No. FC
Architect/Designer's Address
Architect/Designer's E-mail Address
ZHl(o �t G�iWOU�i Ste—
GUMULVSa6SJg4Pv11-b 4144,41l_
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City (J t•((C State EA .-.
i�2` .7 Telephone IN &77•93.33
Zip7
ENGINEER'S NAME Last F S( First dO q Lic.l\C5.rv;i-
Engineer's Address
% y 2 S S� vV 22
Engineer's E-mail Address
S> C �NgI N 8 GM,aI L
City VAN NUyS State G A .
Zip Telephone S( 5.' ZyS
CONTRACTOR'S NAME/COMPANY JJALL(A AR �-
Lic No. IpQ Cq P Class
Contractor's Address
SAN RNTTO 14� _
Contractor's E-mail Address
pt�QAL-tom UFV"jWP-LVOP- P-E, 0PCJ
City F_--- State F
Zip F— Telephone gL(L'1
SETBACKS REAR SETBACKS FRONT
PERMIT NO. 4 � O
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SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK Nlgg�e . Q4?_�P F
USE ZONE DEVELOPMENT NO '??-T09-3 ' 0 U I PLAN CHECK FEES $