HomeMy WebLinkAboutXR2023-2150 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application �EwPo�
City of Newport Beach - Building Division g
Comm'I Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F_ Building r Grading [—Drainage r Elec j—Mech
r Plum CuvdCut F_ CuYdFill
Project Address (Not mailing address) F_ Flood F_ Fire F_ Liq j- Landslide FN/A Floor Suite Nc
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F__ r—
Description of Work
Use F—ConstType
# Stories # Units (if Res)F_
New/Add SFF Remodel SFF Garage/New/Add —
Valuation ^�
Material/Labor_7/coo
OWNER'S NAME Last 1 First K\,cz�
Owner's Address
Owner's E-mail Address
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I�ZS\ BIZ r T IC
City 212L)" State C /'C
Zip F2D2 J Telephone
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APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
City I State F_
Zip F— TelephoneF_
ARCHITECT/DESIGNER'S NAME Last
First Lic. No.r
Architect/Designer's Address
Architect/Designer's E-mail Address
City I State F_
Zip [— Telephone—
ENGINEER'S NAME Last
First E_ It 1-A -P\N k Lic. No. S�GT Z
Engineer's Address
Engineers E-mail Address
7- 3 CO2-1--baATF- tW-2A_0';�?-
i; City State C'
Zip I g7Ly(pb Telephoner —
CONTRACTOR'S NAME/COMPANY
Lic. No. F Class F_
Contractor's Address
Contractor's E-mail Address
City State F
Zip F— TelephoneF —
RZc1Z 38�
SETBACKS REAR SETBACKS FRONT
DCRRAIT Kin \/r7 7 . C7 -T . % 1 Gr.
-TBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO. C2(fL3 (aC��
,E ZONE DEVELOPMENT Nn 11 .a ^" ___^