HomeMy WebLinkAboutXR2023-1965 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application CuP
(— Comm] F_ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F_ Building r Grading j—Drainage r Elec F_ Mech
Plum cuYdCut F cuYdFill s
Project Address (Not mailing address) F_ Flood F_ Fire F_ Liq F_ Landslide FN/A Floor Suite No
Description of Work
Use F—ConstType s
t (lf `
# Stories # Units (if Res)[_
New/Add SFF_ Remodel SF F r Garage/New/Add
Valuation $
Material/Labor F30C 600
OWNER'S NAME Last 22 �� L1 t I L
First
Owner's Address
L L_ (.
Owner's E-mail Address
City tv-e,,,Oo 8r� � State G�
1
Q
Zip Telephone 3g2 Z2! d
D o
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
Z20 Nct�4 4� �}r, Il_ZSL
Kew *VA Llr--,t g"r��f. c�
City �. State (ii'-t
Zip 9��r?a Telephone 31 o _ Q2G-2-2g 0
ARCHITECT/DESIGNER'S NAME Last } wL,(_, 4r&k,4ez1 irs t D Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City SF*�b°^ State r
Zip q2%D 5 Telephone 7 _66t05-6
ENGINEER'S NAME Last SS /LD�r First LicNoT
Engineer's Address
Engineer's E-mail Address
n
/SOD � 4,6
r
1F4-a'4--J e .
City 5,,,,4 � State I Z ' `
Zip g270 V Telephone Fii $3 S _ z, v
CONTRACTOR'S NAMEXOMPANY � L� S p V \L ` l t Lic. No. Fq33331 Class
'O 'ur�lContractor's
Contractor's Address
E-mail Address
ZZa Muvfory �cn (r.
MoAL66 - QU, 0,W5_ �✓r
City �lfv✓�c✓- gry_t!, State �
Zip qZ/�O Telephone 310 _ Z Z�_ 224 D
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SETBACKS REAR SETBACKS FRONT
PERMIT NO. . E�✓�
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $
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