HomeMy WebLinkAboutXR2023-2494 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division o.
r Comm'I r Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL c," E"
(-Building F- Grading F-Drainage F- Elec F- Mech
F- Plum Cu Yd CutF Cu Yd Fill F
Project Address (Not mailing address) Flood
F- Fire F_ Liq F Landslide F_N/A Floor Suite No
Description of Work
Use Const Type F
# Stories a # Units (if Res)F
Valuation $
Material/Labor
New/AddSFF— Remodel SF IF Garage/New/Add I
OWNER'S NAME Last W,Vtltwv IDRFirstI
Owners Address
owners E-maiFAdclress
City State F
Zip q Telephone 4
APPLICANT'S NAME Last Stk �� i
First N(y�
Applicants Address
Applicants E-mail Address
1V341)-GF\N14DN \CSL
ut SSC� iI�(s)Cvx,l�js;�-
City S� tj-, f�, P,N, _ State �—
p
Zip t� 5 Telephone Ti4,
ARCHITECT/DESIGNER'S NAME Last �—
First F Lic. No.
Architect/Designer's Address
ArchitecVDesigners E-mail Address
City State �—
Zip F— Telephoned -
ENGINEER'S NAME Last j(I q D First FQ ) NN U Lic. No. K'a., D
Engineer's Address
Engineer's E-mail Address
I-S?D &zDm,1A0O,L0\0, �4S
R6esA
City s_�►ria �� State I R
Zip I qa, S Telephone) `�1(II � SI D
CONTRACTOR'S NAME/COMPANY �NC+I�c� S`n,-`� �Si Lic. No. I-i440 Classlw-
Contractor's Address
Contractors E-mail Address
l `lr-3�G1—G�tvH�� n/��
city 15A . ,-n IP. tNYT State C�-
I-` u
p�r� I' p
Zip l 1-`�0�" Telephoned 14 S 3�?1 I' 1
t
SETBACKS REAR SETBACKS FRONT
PERMIT NO. XRZQZ7 . 2�� f
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $