HomeMy WebLinkAboutXC2023-0255 - Permit ApplicationPrint Form IWorksheet for Combo Building & Solar Permit Application
F_,/C0mm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F.76uilding F- Grading F-Drainage rAec
Address (Not
31"t3 PRGIFI(� VIEW
of Work
N, W
New/Add SFF — Remodel SF
W/II F—flum Cu Yd cut r— cu Yd Fill
(— Flood r Fire r Liq F- Landslide F—N/A
Floor Suite No
Use F� ConstType r—
�
# Stories # Units (if Res)[—
Garage/New/Add— Valuation3SO, dCJ
Material/Labor
OWNER'S NAME
Last E \) A N First AN Ci
Owner's Address
Owner's E-mail Address
3443 4�RcIFIc, vltw t�rt,;.c
City Gn por } 3 email. State I E ZI
P 'lZ.Cu'rLS Telephones --
APPLICANT'S NAME Last BA C
First I N I _
Applicant's Address
S3 pI G{F�ft�I A �V EApplicant's E-mail Address
city ,#N 13M IL e 1_ PA-b
S(GN S"f k.7ioS
RaillJ� state CA zip `�2tri►--F Telephone !` —7(-7()) -Llosa
ARCHITECT/DESIGNER'S NAME
Last
Architect(Designer's Address
53CI CP-1 FZ+fr.Nl to /kV c, !:t-IOL:
city -,Irv, w__ State FCR
First 10m) I 0 tic. No. III 54 (, 2
Architect(Designer's E-mail Address
Zip . 2_Z 7 Telephone gr-j1 _-L&I _IUc�)
ENGINEER'S NAME Last
First— Lic. Nos --
Engineer's Address Engineer's E-mail Address
City State F Zip [, TelephoneF�
CONTRACTOR'S NAME/COMPANY
pv2�j1-�UG� JQJ`1 Lic.No. JN3;716 Classr—
Contractor's Address Contractor's E-mail Address
/Alloy -ion
City NGw ��y�, State
7 I G ZiP 7 Telephone L III 37 Z J 3s
SETBACKS REAR
SETBACKS LEFT
SETBACKS FRONT
PERMIT NO.
USE ZONE
SETBACKS RIGHT
DEVELOPMENT NO
PLAN CHECK NO.
PLAN CHECK FEES $