HomeMy WebLinkAboutXR2023-1101 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
)— Comm'I Residential City of Newport Beach - Building Division
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Plum cu vd cut[- Cu Yd F01 s
Project Address (Not mailing address) r Flood
(— Firer Liq r Landslide rN/A Floor Suite No
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Description of Work i�� �v
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Use ConstType (//
H Stories # Units (if Res)F-
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Valuation $ ,
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New/Add SF� Remo eI5F Z �j Garage/New/Add �r
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OWNER'S NAME Last .�,''
First
O�wner'ssJAdddress
.Owner's E-mail Address
city t,+i.,iy�3tate G
Zip L �'L Telephone
APPLICANT'S NAME Last /� 5 u�
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First t /
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Applicant's Address
Applicant's E-mail Address
' City State
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- ARCHITECT/DESIGNER'S NAME Last
First F Lic. No. G' Z
Architect/Designer' Address
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Architect/Designer's E-mail Address
City - Sta£e'l
Zip F- Telephones
ENGINEER'S NAME Last �C4--���
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First / Lic. No.
- Engineer's Address M
Engineer's E-mail Address
City State
Zip Telephone
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CONTRACTOR'S NAMEICOMPANY/-'/,
Lic.No. lG.! t3classs
Contractor's Address / /
Contractor's E-mail Address
City � State F—
Zip Telephoned—
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.���/i/
.USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $