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HomeMy WebLinkAboutXR2023-2261 - Permit Application (3)I _ Print Form __ I Worksheet for Combo Building & Solar Permit Application r Comm'] r Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL rBuilding r Grading rDrainage r Elec r Mech F- Plum CuYdCut F CuYdFill Project Address (Not mai 'L l Ma L©N Description of Work ft:�)cD Atz r Flood r Fire r Liq r Landslide F_N/A Floor Suite No 1&I2 JZ T I>C,ACH r— C) If..l A-1,74� New/Add SF + i " 7 Remodel SFF79oq Garage/New/Add OWNER'S NAME Owners Address Last I Y, Q S t VV,, %A,. First I, U L (e Owner's E-mail Address Use I— Const Type 3 Storied— # Units (if Res)F_ Valuation 5 FA 4 6 �/ 0M Material/Labor I 2 I v>1 A Lc� P� I City N�.wnC 01? ` State Lik Zip I — Telephone) — APPLICANT'S NAME Last I (! N✓-_� SO tJ Applicant's Address 2S�[ CC) l 3y c A - CI City State r ESA ARCHITECT/DESIGNER'S NAME Last 7 Architect/Designer's Address l_71S CAN►,.O-I-(iL_ V\Ue City Lc,F State F A ENGINEER'S NAME Engineer's Address -A7,ypra-? DVt; C-73L1 City 1 VZ_v V State I EA Zi CONTRACTOR'S NAME/COMPANY I 'S o 11t�S0 rJ Contractor's Address 2.�31 co&�y city C e S -1 A lM `5 n State C SETBACKS REAR SETBACKS LEFT USE ZONE SETBACKS FRONT SETBACKS RIGHT DEVELOPMENT NO First I `k�E l lva Applicant's E-mail Address ' "�'R_LNj 4 �0 NNSou7)CO cIw aiL. C-o,,%,- Zip Telephone 9c. q '37( 37,Yd First �u wo Lic. No. C704t S7 Architect/Designer's E-mail Address Zip CIO 7% Telephone , 6Z CDT 77 > Last (� � L+vTxLVrst� l Engineer's E-mail Address Lic. No. L96Lt77 K3e KK S`Tz�c'-(, co p 4- Z 6/ y Telephone T 1�/ /83&i CONS r Lic. No. 8 �335-91assF - rrav Contractor's E-mail Address I BIZ I -JIT -k H0t Q Q 7 (P o, ^ (L. , c o � Zip q- GZG Telephone qqC, `3-71 39yo PERMIT NO. 0 .. PLAN CHECK NO. ?CZOZ PLAN CHECK FEES $