HomeMy WebLinkAboutXR2023-0948 - Permit Application_ Print Form Worksheet for Combo Building & Solar Permit Application
r- Comm'I residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
I� v
Building F_Grading F-Drainage rElec F_Mech F-Plum Cu Yd Cut[_ Cu Yd Filll
Project Adddre�ss (Not mailing address) f- Flood F_ Fire F_ Liq r- Landslide F_N/A Floor Suite No
Description of Work
Use ConstType
W Ta C a r r�Pi c.✓ r Serer
# Stories #Units (if Res)
Valuation
Material/Laa bor
A f
New/Add SF Remodel SFI JW Garag a/New/Add
OWNER'S NAME Last `��E� First I _f30N/`X2
Owner's Owner's E-mail Address
//Address /{ �-
city SPA- State Zip Z TelephoneF—
APPLICANT'S NAME Last �i'/I%��ii _-/ First I I 'p*,L
Applicant's Address Applicant's E-mail Address
r� -
City jm1< State �— ZiP qZ 3 Telephone
ARCHITECT/DESIGNER'S NAME Last — First F �l
Lic. No.
Architect/Designer's Address Architect/Designees E-mail Address
City State Zip TelephoneF—
ENGINEER'S NAME Last First �—® Lic. No.�—
Engineer's Address Engineer's E-mail Address
City � State F_— Zip I — Telephone I'
CONTRACTOR'S NAME/COMPANY so Cq l C �Iro�A7ic. No. 7Class rz
Connttracc/tor's Address Contractor's E-mail Ad(
d�reesss E 1300 S g
I n
State City ���'P,/) FcA -Zip qZ Telephone it `4 To - oGi(/A�
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO, PCB 3 - D t G D
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $