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HomeMy WebLinkAboutXR2023-1963 - Permit ApplicationIIJ Print Form I Worksheet for Combo Building & Solar Permit Application �EWPoq> I- Comm'I F_ Residential City of Newport Beach - Building Division o `' NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL f-Building F_ Grading F-Drainage F/lec Pech r7PIurn CuYdCut CuvdFill Project Address (Not mailing address) C Flood F_ Fire r Liq r Landslide FN/A Floor f Suite Noo— �3�z PaG'/c _ �f• ��Ul2a{— � �'1Gwt' Description of Work Use ConstType C�eo�tlbs7 a tt�a a� 3-Stogy � �e #Stories #Units (if Res) U New/Add SF Valuation $•' 70i Remodel Garage/New/Add %� _ Material/Labor /7+•e�-� - -- r- OWNER'S NAME Last 2322 PNC' First -- - _-t-E�_L_� L_LL Y fo(s^i Owner's Address Owner's E-mail Address LE 04 City AAo .. (J--- State ZiP -�p Telephone �;7 rLJ APPLICANT'S NAME Last FS ij First ra5� Applicant's Address Applicant's E-mail Address OILrc+L5 City I 5cr vtC0- ka� State �j p ^� ------ - --- �'.`— _ ZiP 1 Z�© Telephone <-��_ 2 0510 ARCHITECT/DESIGNER'S NAME Last First F Llc. No. -- Architect/Designer's Address Architect/Designer's E-mail Address City State Zi elephone�— ENGINEER'S NAME Last /� UNt First Fad Lic. No. C 3 6 4, 0 Engineer's Address Engineer's E-mail Address City 5B i![ of YIPS State p � 7 phone - -- ..._._._Zl 2 0 Telephone FIVE 35 Z800 CONTRACTOR'S NAME/COMPANY Q F_ I��GT V t y' Lic. No. Class Contractor's Address Contractor's E-mail Address 3 �3' City State �— zip F— Telephone -- SETBACKS REAR SETBACKS FRONT PERMI N SETBACKS LEFT SETBACKS RIGH _ . PLAN CHECK N0. fC� SE ZONE