HomeMy WebLinkAboutXC2023-0010 - Permit ApplicationPnnt'Form" 11V465rfcsheet for Combo Building & Solar Permit Application I
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Comm'I (- Residential City of Newport Beach - Building Division c
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL o ,
Building F_ Grading F-Drainage r Elec F_Mech
F_ Plum Cuvdcute— Cu Yd Fill e
Project Address (Not mailing address) C Flood
(- Fire (- Liq F_ Landslide f N/A Floor Suite No
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Description of Work
Use e ConstType G -g
# Stories # Units (if Res} (�, o
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Valuation 5
New/Add SF�� Remodel SF i,00�Garage/New/Add F_
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Material/Labor r 50 t_ I
OWNER'S NAME Last bpi Lee
First fcrIR-k .
Owner's Address
Owners E-mail Address
City jUft,tly;ci Pr'rr(-Gt State t
Zip `-17-G:6C, Telephone
APPLICANT'SNAME Last AV, . -cs .vr
First t\ti-e_
Applicant's Address
A.pplicarifs E-mail Address
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State ('A
City t-ii dw r,,,, Ci
Zip j Z E Telephone ]1lJ-
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ARCHITECT7DESIGNER'S NAME Last `RYm 01(11q
Firs Lic. No. t 8sY5
FArchitect/Designer's
Architect/Designer's Address ✓J
E-mail Address
City State
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zip tT'�( S- Telephone jl�i--479 �E 6
ENGINEER'S NAME Last [—
First F— Lic. NoF
Engineer's Address
Engineer's E-mail Address
City F---- State F
Zip F Telephoned
CONTRACTOR'S NAME/COMPANY RAq r VI {tiYY7 v
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l7 ( /t -��� Lic. No. t� y�j'? Class 6 r
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Contractor's Address
Contractor's E-mail Address
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Goff
City ��.1DP)J,. Cory State
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Zip q2(� 7 Telephone ,y �j36_d�ylo
SETBACKS REAR? SETBACKS FRONT
PERMIT NO. i�G2D2S 0070
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO, 0120
6SF 7nNF nFVFI nPNAFNIT Nr) ?gA,0i?b • 00ki PI AN CHECK FEES S