HomeMy WebLinkAboutXR2023-0043 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F- Comm'I FX Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
uilding r- Grading F-Drainage (-Elec F_Mech F' Plum CuYdCut 7 CuYdFill I `I
Project Address (Not mailing address) F_ Flood r Fire F_ Liq F_ Landslide I -N/A Floor Suite No
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Description of Work
Use F— ConstType
AP-P A4z�
# Stories #Units (if Res)
jD.Aitx
Valuation
Material/Labor IT760
New/Add SFI _7�_ — Remodel SF F Garage/New/Add
OWNER'SNAME Last First
Owner's Address Owner's E-mail Address
G1�,S%tcgaY Fs �.� a 111�. ccf
City State � Zip 1 7 z-46-7 Telephone ,%gyp _ GO �7 ,7
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APPLICANT'S NAME Last � First \4 .GS ke
Applicant's Address Applicant's E-mail Address
City j //A_,7 A4e State �— Zip g� Telephone
ARCHITECT/,DESIGNER'S NAME Last First �— Lic. No. F
Architect/Designer's Address Architect/Designees E-mail Address
City State F Zip F Telephoner
ENGINEER'S NAME Last &eel-eSvt� First 'f8i3p
- �vY qnJ � Lic. .j
Engineer's Address Engineer's E-mail Address
2��y8 fluff If 'I
City //_,j 2.4 State ZA Zip '/Z.32% Telephone 96 f 331, 970
CONTRACTOR'S NAME/COMPANY Ff ✓/C U-tll Lic. No. ClassF
/� � 2� � OJ,�J�f✓
Contractor's Address Contractor's E-mail Address
City % L� State �C Zip <fZJ�v Telephone 4 z" _Up40 4"1y,?;>
SETBACKS REAR SETBACKS FRONT PERMIT NO. < ZUZ 3-- 00 .3
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. C'Z023 -- VVq
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $