HomeMy WebLinkAboutXR2023-1750 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F- Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building r Grading (-Drainage j- Elec F_ Mech r- Plum CuYdCut F_ CuYdFill [_ I
Project Address (Not mailing address) (- Flood r Fire r Liq r Landslide FN/A Floor Suite No
`��(-�, v=e5rNu,,r:4-cr
Description of Work
Use F_ Const Type F_r�
#Stories #Units (if Res)
c-bu
"
AGLor� ta►-� 1 oor- __
Valuation $ �,
jm6
New/AddSF� RemodelSFF Garage/New/Add—
Material/Labor[�V
OWNER'S NAME Last First G &aLs p w
Owner's Address Owner's E-mail Address
Ave- C�oc�nrgistMe Cc�w��t. tcsw�
City N� Lam} State C4 Zip F_q) /_ Telephone ')I L} •- 34tj-�1'(rj!
1L'��
APPLICANT'S NAME Last 4 <rA Lv� FFiirrstP
Applicant's Address Applicant's E-mail Address
Ave— ck.," +'sue e AAC�i 1,
_e~-
City 'Vim,} �G� State (?,,;�i Zip �� Telephone '%lij.3yt7—gtC.�9
ARCHI�T�E`C"TT/'D-iE"SIGNER'S NAME Last j� r S( G First X Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
Ua�H" br k, b'"p 5YV\64�1-
city �t SJ vl� cia State C, Zip F9i�sipTelephone '71i4'(ol 12—(P3Ne
ENGINEER'S NAME Last �IJ �tw First ��.� Lic No.F—
Engineer's Address Engineer's E-mail Address
C9 v Ve vt b-S r 1,41 cK t 3t,�C, Lovr,
City /%1 I U l e � L% State C 4 Zip �Z (ems/ Telephone 71 C1 _(p(Z>(j R lie
��P
CONTRACTOR'S NAME/COMPANY j _ _Lic No. j 1 OQ I � Class
C���-��s � 'rUC-�I
Contractor's Address Contractor's E-mail Address
�c yv�e Y c - l ✓10� Wl y r c�c4
City ��C State C>a Zi a] Telephone, 513� �f I�,
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NOQLLm-1j • I54l,
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $