HomeMy WebLinkAboutXR2023-2532 - Permit Application (3)orm I Worksheet for Combo Building & Solar Permit Application
m'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building r Grading rDrainage _ Elec
Project Address (Not mailing add
293�1 PoQ-r Ctl:es—s.F� P1
of Work
�-r2�ifV �- W4FLl_ INSIDE
New/Add SF F_ Remodel SF
r Mech
r Plum
Cu Yd Cutl
Cu vd Fill
l r Flood
r Fire F
Liq F Landslide
rN/A Floor
T'� *:w Pa rzT- 6,qEocH c126F_
OWNER'S NAME Last N,R I L�1rV Ci
Owner's Address
I qi I Qc7 Q i C�YrL� t FF PI .
City I N tAIJ PC) rtT. 9 n*A� State 55
APPLICANT'S NAME Last _;R � L�
Applicant's Address
City Po G, Ge State
ARCHITECT/DESIGNER'S NAME 1
Last_
Architect/Designer's Address
City
ENGINEER'S NAME Last
Engineer's Address
City
CONTRACTOR'S NAME/COMPANY
Contractor's Address
City
SETBACKS REAR
SETBACKS LEFT
USE ZONE
Use F—Const Type F_
n/£ IS" fl i 6r{
# StoriesF_ # Units (if Res)
Valuation $ i5 p O Garage/New/Add �— Material/Labor
First NA rV
Owner's E-mail Address
Zip q� Z(�(�(J TelephoneF _
First I N I LoL_1
Applicant's E-mail Address
Zip F--al j�(,, Telephone q� ,q R33 ' 6
First �— Lic. No. Tr—
Architect/Designer's E-mail Address
State F Zip F TelephoneF —
First
Engineer's E-mail Address
Le. No.F�
State -- Zip r Telephone[ —
Lic No. F ClassF
Contractor's E-mail Address
State �— Zip F Telephone
SETBACKS FRONT PERMIT NO,
SETBACKS RIGHT PLAN CHECK NO.
DEVELOPMENT NO PLAN CHECK FEES $