HomeMy WebLinkAboutXR2023-2053 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application
r Comm1 r- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FFFC N IF: AT TIKAM nc of IDRAI Al
r-Building (- Grading j-Drainage j- Elec r Mech I�
j- Plum Cu Yd Cutl Cu Vd Fill
Project Address (Not mailing address) r- Flood r Fire r Liq r Landslide rN/A Floor Suite No
Description of Work
Use F Const Type
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,
# StoriesF_ # Units (if Res)F—
Valuation $
Material/labor
5 r
New/Add SF �— Remodel SF�- Garage/New/Add F—
OWNER'S NAME Last
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�SCcil�� First
Owner's Address
Owner's E-mail Address
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City ��, (\O`l _aL State F C Zip Z66(J Telephone
APPLICANT'S NAME Last
First f -.
-
Applicant's Address
Applicant's E-mail Address
City
41 fi__2-0 C�.
State F
Zip �2ELbc.` Telephone gQg-(13ct—CjU -3L)
ARCHITECT/DESIGNER'S NAME
Last buT First C.hJ� � � — Lic No. F_
ArchitectlDesigner's Address
Architect/Designer's E-mail Address
Cl%21 OA�pAl- <_ K-,,/
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City \ t (L
CL\ State G` Zip g2_ fV Telephone Gt5q--W -3t1
ENGINEER'S NAME Last
�,.)CSiRc First Lic. No. 1K �i 5 2_7
Engineer's Address
Engineer's E-mail Address
18C Cj E- 16k\
�5i wne t Cat
city S,, _ n -
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State C,� Zip 9Z`It^j { Telephone l
CONTRACTOR'S NAME/COMPANY
Lic. No. bQp Class
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Contractor's Address
Contractor's E-mail Address
city ,(�, �et_
c,�State C'� Zip �Z � Telephone c?Il{C.lU j t
SETBACKS REAR
SETBACKS FRONT PERMIT NO. )<gZ.M'3! 205,
SETBACKS LEFT_
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES S