HomeMy WebLinkAboutXR2023-0059 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application%��E"°°q>a
City of Newport Beach -Building Division
Comm'I Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F-Building FGrading F-Drainage F-Elec F_Mech
F-Plum Cu vd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood
j— Fire F_ Liq F_ Landslide F_N/A Floor Suite No
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2(" 63 F �—
Description of Work
Use F_ Const Type
# Stories? # Units (if Res)F_
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Valuation $ `<
New/Add SF � Remodel SF 6X� Garage/New/Add
Material/Labor , C, 'I
OWNER'S NAME Last tTCJ6C_A7I c_e
First K�lJt1c�
Owner's Address
Owner's E-mail Address
P.-,H, C)L..C2�oA,�
City 1 &2 6 State
Zip q2��,� Telephone r l
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
City State F_
Zip F TelephoneF
ARCHITECTIDESIGNER'S NAME Last t`iI�F�
First (�v�n=> Lic. No. CY3�N.Ed2
Architect/Designer's Address
Architect/Designer's E-mail Address
City State
Zip Telephone
ENGINEER'S NAME Last First Lic. NoF
Engineer's Address
Engineer's E-mail Address
City State F_
Zip Telephoned
CONTRACTOR'S NAME/COMPANY
Lic No. ClassF
Contractor's Address
Contractor's E-mail Address
City State
Zip Telephone
SETBACKS REAR SETBACKS FRONT
PERMIT NO. M ZVZ 3 - 0059
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. f CZCZ3- 0066'
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $