HomeMy WebLinkAboutXR2023-2221 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application ROW
r Comm] r Residential City of Newport Beach - Building Division
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rBuilding r Grading -Drainage r-Elec rMech r plum Cu Yd cutF_ Cu Yd FittF_
Project Address (Not mailing address) F_ Flood f Fire f Liq r Landslide rN/A Floor Suite Nc
Description of Work le
Use Const TypeF
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# Stories # Units (if Res)F—
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New/Add SF �— Remodel SF Garage/New/Add �—
Valuation $
Material/Labor 2 j L� l./t.t
OWNER'S NAME r
Last ' \,�t ( �. ,GL' First /� et
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Owner's Address
Owner's E-mail Address
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City J.� State C� ZIP 31 Telephone l L,'I �� f/
APPLICANT'S NAME Last (/ r7, {� First
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Applicant's Address Applicant's E-mail Address
City , , - ,,. �� � State Zip 2 t Telephone %1 V
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ARCH TECT/DESIGNERS NAME Last First F_ Lic. F—
No.
Architect/Designer's Address Architect/Designer's E-mail Address
City � State F_ Zip �— Telephone[ —
ENGINEER'S NAME Last �'V First �— Lic No.F—
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Engineer's Address Engineer's E-mail Ass
City I State F_ Zip [_ TelephoneF—
CONTRACTOR'S NAME/COMPANY Lic. No. " �G� 7Class�
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Contractor's Address J/LIB)_ I '� I I I 'f; j
t` L �`t',1 U4 O`�n � � 777 •�' Contractor's E-mail Address
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1�TelephoneCityNd/Ult 5�1t_ '� L/S� GU
State
A,
SETBACKS REAR
SETBACKS LEFT
USE ZONE
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
PERMIT NO
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PLAN CHECK NO. _ /U 0 - (Gi�1�
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