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HomeMy WebLinkAboutXR2023-3001 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application W�"e City of Newport Beach - Building Division � T F_ Commit (- Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL U F_Building rGrading F-Drainage rElec F_Mech F_PlumCu Yd Cut F_CuYdFill r— Project Address (Not ma/tiling address) f Flood r Fire F_Liq j- Landslide F_N/A Floor Suite No So`7 //Y- Dr,",T> /-Felt s2oi +k C VG-� vv(RP- Gk 4z6i.2s Description of Work Use F Const Type F # StoriesF_ # Units (if Res)F_ Valuation $ Material/Labor Zaar omo New/Add SFr— ' Remodel SF /r Zo Garage/New/Add �— OWNER'S NAME Last tJtts,+t-ro,J First Owner's Address Owner's E-mail Address 5D'1 112- oqP .4,D /erg City G otz-fl,,,,a -Dr, Vvt . p_ State I / I -- Zip `t2G2S TelephoneF— APPLICANT'S NAME Last g..1.y rpm �r First I I W r .(-- Applicant's Address Applicant's E-mail Address /23% `OUwa `i � vE t City Z ,-,4 V,,L •, State �— Zip -ZfL2S Telephone 9-1- 2't3' 7-4-1152 ARCHITECT/DESIGNER'S NAME Last ©KELi-/4tiA First— Lic No. Architect/Designer's Address Architect/Designer's E-mail Address City State F_ Zip F— Telephoner -- ENGINEER'S NAME Last First F_ Lic. No.r— Engineer's Address Engineer's E-mail Address City State �— Zip ri TelephoneF CONTRACTOR'S NAME/COMPANY Lic. Nd� Classr-- Contractor's Address $ro7Ll z� Contractor's E-mail Address City State F Zip F_ Telephone F_ SETBACKS REAR SETBACKS FRONT PERMIT NO,u%�'3^� SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE _. _ DEVELOPMENT NO Pl AN cuFru r=Gcc c