HomeMy WebLinkAboutXR2023-1966 - Permit Application (3)Print Form Worksheet for Combo Building & Solar Permit Application
r Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding r Grading r—Drainage F_ Elec r Mech
f-" Plum CuYdCut i CuYdFill
Project Address (Not mailing address) r— Flood r Fire r Liq r Landslide F_N/A Floor Suite No
Description of Work
Use s Const Type F
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v,,
# Stories # Units (if Res)s
p f ff gI
Vn\ / po IT 3 bC[�i�.�iKoO�
Vr i
Z i
New/Add SFF Remodel SF F Garage/New/Add
Valuation $
Material/Labor 2-2_t poo
OWNER'S NAME Last 'z3 L2 �� L1 t 1 L
First
Owner's Address t
Owner's E-mail Address
6 ,/ e �
City An.,,,0o $._ �/1 State I
Zipje5Telephone 31-22g a
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
2.Z0 Ncwlf;,-� r Dr. 11-2-Si-
Keno *V4L(4 co,
City N�w�w t �r State F_5�_
Zip 4� Telephone 31 o 221 D
ARCHITECT/DESIGNER'S NAME Last npt-c 4Yxi4e_ �oj p. �irs 1 0 Lic. No. F_
Architect/Desig��nerr''s// Addressll
Architect/Designer's E-mail Address
�G `L'�17'Lf� r�r�s� \b
4rr-r'Q9_ a4jxe4j . &P-1
City S`b°" State I "'Z
Zip ¢2`�O'Tj Telephone 71I(bj_-O
ENGINEER'S NAME Last .-5-r pLC6r First Lic No.F——
Engiineer's Address
Engineer's E-mail Address
!! �}, Q
/900 f, �b 7"r JS
/ - /'
T^r4__ e �S1'T�^�G . 6,1
City 5�,4,, P State r (/A
Zip ?7 7O Telephone Fit (L _ g 3 57 �(g
CONTRACTOR'S NAME/COMPANY L� S /I v\l t Lic No. FY333 d Class
'O
Contractor's Address
Contractor's E-mail Address
ZZo N��cu�o� Cc•�y �1 � - r 1-
rho @ ivto+� �-EJ Q � � s _ !� .•ter
city glyx-1, State 1
Zip qZ/(, 60 Telephone 3f o Q — 1 26_ 224' a
SETBACKS REAR SETBACKS FRONT
PERMIT NO. p- 6 b Ul O
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. k1�3
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $