HomeMy WebLinkAboutXR2023-2935 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application a 2`
F- Comm] (✓Residential City of Newport Beach -Building Division o- `-
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
r-Building r— Grading
r-Drainage rt�ec j—Mech lum CuYdCut F_ CuYdFill s
Project Address (Not mailing address) r Flood r- Fire r Liq r Landslide I —N/A Floor Suite No
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I jQ e•.Jpor+- CC)c_-, ' / GA-� q.26,C7 F F
Description of Work
Use ConstType
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# Stories # Units (if Res)
ACJ �a o0t� �\Wf.�
Valuation $ 'A %ZCD't5o
Material/Labor
New/Add SF�
RemodelSF��'� Garage/New/Adds—
OWNER'S NAME
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Last GTM(\p U-L. First F /)k
Owner's Address
Owner's E-mail Address
6 GicarU e s
N (A
City [Qe,-))� r+- Gx_%N- State C,'�- Zip R26� 7% TelephonePA-
APPLICANT'S NAME
Last First I -t,lllor)
Applicant's Address
Applicant's E-mail Address
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City =fJ tom.
State Zip � �6 i Telephone 5� 5
ARCHITECT/DESIGNER'S NAME Last 10 > First `�e-i_e1" Lic. No. 203 �q2p
Architect/Designer's Address
Architect/Designer's E-mail Address
3�31 54' 6cu:,c Lcr4t Qc:v� j JSi-U()%C)% 0JMokl.Co^�
City I `Nt-�NN(.A
State Ok Zip q%7_3c{ Telephone 9l1 601 Fz33
ENGINEER'S NAME
Last First F Lic. NJ —
Engineer's Address
Engineer's E-mail Address
City
State Zip I Telephone�—
CONTRACTOR'S NAME/COMPANY�ChS N �oMes Lic. No. IClass
Contractor's Address
Contractor's E-mail Address
ail\ors 07 i�enriG!'SetS:^oMp
City
State CGS Zip I Z(a (P, Telephone 9q 5 SST 7C?
SETBACKS REAR
SETBACKS FRONT PERMIT NO. 21 Z , 2 q
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. ` 2
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $