HomeMy WebLinkAboutXC2023-0448 - Permit Applicationr Print Form I Worksheet for Combo Building & Solar Permit Application
r Comm'I r Residential
City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Note mailing address) F_ Flood F_ Fire F_ Liq F- Landslide F N/A Floor Suite No
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of Work
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OWNER'S NAME Last I 4�i I
Owners Address
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City I tj 6u?pf-r r-9-A-0- State
APPLICANT'S NAME Last
Applicant's AddresA�s�� t�� � �®
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City ,V State
Garage/New/Add F—
ARCHITECT/DESIGNER'S NAME Last �—
Architect/Designer's
Address r'
City .Efi�jg,7(- _._ State
First I I -" / A/
Owner's E-mail Address
Zip
First
Use F_ Const Type v/ i
# StoriesFT # Units (if Res)F_
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Applicant's E-mail Address
Zip f�p�p`� Telephone 7Ltj
First jE C_ Lic. No.
Architect/Designer's E-mail Address
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ENGINEER'S NAME Last F-65�— First ✓, Lic. No.
Engineer's Address
1500 e r% 11TE
City Skki-n 4wA State
CONTRACTOR'S NAME/COMPANY
Contractors Address
City
SETBACKS REAR
SETBACKS LEFT
USE ZONE
Engineer's E-mail Address
Zip T-70 / Telephone
Lic.No. F-- Class
Contractor's E-mail Address
State r Zip F— Telephoned
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SETBACKS FRONT PERMIT NO. /��-' ?yY�% •`'(
SETBACKS RIGHT PLAN CHECK NO. '•�'t-7/l7 L 7� ' ZLdl'S
DEVELOPMENT NO
PLAN CHECK FEES $