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XR2023-0889 - Permit Application
Print Form Worksheet for Combo Building & Solar Permit Application r Comm'I r Residential City of Newport Beach - Building Division a NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL rBuilding F- Grading F-Drainage F_ Elec r Mech r Plum CuYdCut CuYdFill F_ Project Address (Not address) r Flood r Fire r Liq r Landslide FN/A Floor Suite No gmailing Description of Work Use F ConstType F �� �%m0��, Intl i� Q 9�A. 11 S S I_r V &QW , Pe, #Stories #Units (if Res) -T ())ors pinrn3j. E1v�fi�lec ��pla�c y�wL�� Valuation $ New/Add SF� Remodel SF 130%5 Garage/New/Add � / I �� Material/Labor OWNER'S NAME Last First Rober�- Owner's Address Owner's E-mail Address 21b F ©r W_Fro(r City State Zip F- Telephone 2 a25 APPLICANT'S NAME Last W 'Z First j Applicant's Address Applicant's E-mail Address City I VNM State GK Zip 1 TelephoneF ARCHITECT/DESIGNER'S NAME Last 15e.8 First F Lic. No. r31 3jS (S r r Architect/Designer's Address Architecl/Designer's E-mail Address W0-z- )P, qwl olI . Cod City State F Zip F Telephone eM lb30 -5q39L ENGINEER'S NAME Last First F_ Lic. No.F Engineer's Address Engineer's E-mail Address City State F__ Zip F_ Telephoned CONTRACTOR'S NAME/COMPANY �/ V" 1 /t `^�.',( j � C, Lic. No. r��ClassF , / `Contractor's Contractor's Address E-mail Address City State F_ Zip F Telephoned p x SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $