HomeMy WebLinkAboutXR2023-1966 - Permit ApplicationP;Oi rorrr, I Worksheet for Combo Building & Solar Permit Application ` °R>
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F Comri F_ Residential City of Newport Beach -Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F_ Building F_ Grading F-Drainage F_ Elec (- Mech
F Plum CUYdCut CuYdFill
Project Address (Not mailing address) F Flood F_ Fire F_ Liq r Landslide [_N/A Floor Suite No
R_3 22
Description of Work
Use F ConstType F
#Stories #Units (if Res)
I YAr ✓ 1
Valuation $
Material/Labor l��O
New/AddSFF_— Remodel SFF-- Garage/New/Add —
OWNER'S NAME Last 232 j- ��Ll `
First
Owner's Address i
LL_6,
Owner's E-mail Address
22o VnI-A2 S i
City tsty, 0,q ��7 State c�
Zip a Telephone 3 1 0
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
1--2o NCV-04 V,
AvALe-5 gv l ff. Csr1
City �. State Ic;
Zip (1 ' Telephone 31 o _ g2�_22g o
ARCHITECT/DESIGNER'S NAME Last G ,7 j ,� ]-^
rt p,. irs'It�`-ia LicNo.
Architect/Designer's Address
Architect/Designers E-mail Address
City S �` n� State �
Zip 4'�`�O �j Telephone 7 tD56
ENGINEER'S NAME Last 1 EP P"t-6, _77LC First F Lic. No F—
Engineer's Address
Engineer's E-mail Address
lgoo i s� �t j
I IP,-r4-J e err- . 6,-
City .SN,4° State (1
Zip Q'�`70 Telephone `7 ((_ _ g3 � �ji�
CONTRACTOR'S NAMElCOMPANY w Lz I p U\L ` l Z Lic. No. 93333 I Class 3
Contractor's Address
Contractor's E-mail Address
ll ,�� �.�,-'
2-7-0 &te_we,,j LG�( r. I t -
/�
�ZJ�o /Vl0141 LEJ U U S - 'o .✓I
city ,Por �. ���. t, State F
Zip Telephone 3 j o _ g L�_ 2'Lg D
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO,
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES