HomeMy WebLinkAboutXR2023-1216 - Permit ApplicationPrint For Worksheet for Combo Building & Solar Permit Application oc`' ° m
[- Comm'I Q Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building [- Grading [—Drainage [- Elec [- Mech
[- Plum Cu vd CutF Cu Yd Flu
Project Address (Notmailing address) [- Flood
[- Fire [- Liq [- Landslide [-N/A Floor Suite No
Description of Work
Use F�DF Const Type 5
KffLLti "'! -, kiL�t2.l Or2 �
J
# Stories # Units (if Res)r—
.s
Valuation $
Material/Labor /000
New/Add SFr— Remodel SFr Garage/New/Addy—
OWNER'S NAME Last NFAL,
First
Owner's Address
Owner's E-mail Address
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City Ny,&t2 foR,i i{&q.� State I (
tLasta(
Zip jZ &o Telephone
APPLICANT'S NAME
First
Applicant's Address
Applicant's E-mail Address
City State F_
Zip F_ Telephoned
ARCHITECT/DESIGNER'S NAME Last �IZ�
First b Lic. No.
ArchitecttDesigner's Address
Architect/Designer's E-mail Address
Ot/ Iv '�-LS�UL S�t. /'l�°' +-�''l
7 c� IM._qo�,stZor StG�W
City 6vs-� P Eg State �
Zip pI GtP,l�� Telephone �
ENGINEER'S NAME Last
First�R Lic. No. �%0'142
Engineer's Address
Engineer's E-mail Address
2} 2it I/ L {i`�JF b2_.. , ✓U ( i� DO- t3�,COv-,
City ( l State I C
Zip U� Telephone -J {C JeEz 3&,n (
CONTRACTOR'S NAME/COMPANY �� L
Lic No. i72 _�n Class i
Contractor's Address
Contractor's E-mail Address
)S � C1017 N ll��CE2nS 171p
/JL l C Gd x %t%'j .
City State CA
Zip /Z�_2 Telephone 1'71q
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $