HomeMy WebLinkAboutM2023-0079 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application 023
F Comm'I F Residential City of Newport Beach - Building Division
NOTE' PLAN CHFr:K FFFS nI IF AT Tinno nr OI ioeurr.
[-Building F_ Grading F-Drainage F_ Elec r Mech r Plum CuvdCut F CuYdFill F_
Project Address (Not mailing address) IF_ Flood F_ Fire F- Liq F Landslide rN/A Floor Suite No
Description of Work
Use F— ConstType
# StoriesF # Units (if Res)[_
Valuation $
Material/Labor SC, C:C<,
New/Add SF�- Remodel SF �—
Garage/New/Add �-
OWNER'S NAME Last S(
First +
Owner's Address
Owner's E-mail Address
city State CN
t'�c�t l . C
d
Zip 9i. 2J Telephoner
APPLICANT'S NAME i
Last tl-E ��
First �cZ
Applicant's Address
Applicant's E-mail Address
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jC\e-iIAr\c�kLr� ai.Ll'l^r�
City s�a � fit, State ,fi
G�!
Zip � Z� Telephone �C.c7 �-y,J
s-3Str
ARCHITECT/DESIGNER'S NAME Last F—
First F_ Lic. No. F_
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
City �� � State [_
Zip TelephoneF_
ENGINEER'S NAME Last �%-�\/
__ (i;� 4
First Til Lic No. OC 1
Engineer's Address
Engineer's E-mail Address
City State
Lal
,� .CL Mr rt. C. ( (_'
J .� 1 -�
Zi Tele hone
P qWi ) p 1
CONTRACTOR'S NAME/COMPANY
,A
Lic. No. ' i i � Classr-
Contractor's Address
Contractor's E-mail Address
r C
City I r L C� State
Zip 13: tj) Telephone �� 'j� _ 7 y
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.QG
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $