HomeMy WebLinkAboutXR2023-0877 - Permit Application'rint Form Worksheet for Combo Building & Solar Permit Application feiComm'I esidential City of Newport Beach - Building Division���.e}.����c.�.NOTE: PLAN CHECK FEES DUE AT TIME OF SUBM14 C• �' )
Building F- Grading rDrainage rElec F_Mech F- Plum Cu vd Cut Cu Yd Fill F
Project Address (Not mailing address) F_ F- Fire r Liq F- Landslide FN/A Floor Suite No
50AvP�ZrFT I —,�—
Description of Work
Use P/() Const Type I v —
I JlA ���- L�1p7JITk�IJ �4iiJJ i/�7 k7�'J'%O y �9✓V7
IF Stories # Units (if Res)[ —
Valuation $
Material/Labor 30of C-t2o
New/Add SF Remodel SFGarage/New/Add F_
OWNER'S NAME Last �/�
First I JOH,U
Owner's Address
Owner's E-mail Address
/ /2- XX1
(,,� Gh�4lL . GbM
City I C0904A p6-7— HAP— State I ZA
Zip y'2jg�26_ Telephone ?j � G0( j2
APPLICANT'S NAME Last A jSZJAj
First I F4- -
Applicant's Address
Applicants E-mail Address
2732 E. C®ASi yyivy 5'U/i= e3
�Usz/NPL � ��L '�''`�
City Cl7�pN� ��L State cA
Zip 9Z� Telephone
ARCHITECT/DESIGNER'S NAME ?
Last G�-//�rjs First Cy�� �Lic. No. G- 22/ 8
ArchitectMesigner's Address ; q
Architect/Designer's E-mail Address
GYN7�i�i cN���s �-+a��/.
CG?-lILDS�GGr4lZGl-/ITEGT rG01/L1
City I C {/i2�JAi�J State
Zip RZEZC� Telephone g/_7/g-�75Z0
ENGINEER'SNAME Last
First Kra Lic.No.
Engineer's Address �/ ��J6)�JgC7�� >f(7
Engineer's E-mail Address
l 76`g5-ly,4,evA✓ P AV E Sv/r : C-7N
kA 6) sT.2xT , GvM
City IR_U/WE State Cam]
zip �� Telephone
CONTRACTOR'SNAME/COMPANY ry�� �Y1f]/eu C �N� Lic.No. Class
Contractor's Address
Contractor's E-mail Address
"7 t)C1Z Fog b�
►� �lu�t
City v 12; State
Zip Telephoneff*65,6_sLxQ
ETBACKS REAR SETBACKS FRONT
PERMIT NO.
TBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. CC.Zffl._S — 077
ZONE DEVELOPMENT NO
PLAN CHECK FEES $