HomeMy WebLinkAboutXR2023-1925 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
r Comm'1 Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding f Grading rDrainage r Elec r Mech i— Plum Cut ydCut cuYdFill s
Project Address (Not mailing
address) i— Flood r Fire i— Liq (— Landslide FN/A Floor Suite No
Description of Work
Use F—ConstType F_
# Stories # Units (if Res)s
New/Add SF Remodel SF Gara a/New/Add
F- 22 �; g
Valuation $
Material/Labor
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OWNER'S NAME Last
i_ C) "T, i First ?.Z A
Owner's Address
Owner's E-mail Address
City lV i 1•o J/L v� C
State (k�i- Zip (6i- Telephone c(
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APPLICANT'S NAME Last
I-� 1 FI First �
Applicant's Address
Applicant's E-mail Address
c V LS ^
I Lfj r I L MAIL. Cc%M
City 111� /rjZ,f 77,x.(/ ..
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State Zip Telephone cFr(
ARCHITECT/DESIGNER'S NAME
Last �'j}r�. �% First h r, Lic. No. C S i U
Architect/Designer's Address
Architect/Designer's E-mail Address
1("
_
J�Ij}A,1jLr IL,Fif✓ I r 11LC6!'1
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City r; CD7:a.k.,, �, TU - ✓r
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State ZiP F Telephone FI �-
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ENGINEER'S NAME Last
First Lic. No.F_
4,01k
r' cL(1_V y
Engineer's Address
eA4 Engineer's E-mail Address
City
State F_ Zip F Telephoned
CONTRACTOR'S NAME/COMPANY
C )IRIS :.V I L -r Lic No. F—Class F —
Contractor's Address
Contractor's E-mail Address
319I Car C r
y C 6 -J C-,N1i
City I C Ly
State C..`F Zip Telephone 7C,tl_29Cy•.y'j3p
SETBACKS REAR
SETBACKS FRONT PERMIT NO. �C f�wl/7j IC( Z.5
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $