HomeMy WebLinkAboutXR2023-2747 - Permit ApplicationPrint Form I 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
42EWPORT
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F_ Building r Grading j—Drainage tElec Nvlech NPIUM CuYdCut CuYdFih
Project Address (Plot mailing address) 1-'Flood F_ Fire r Lid r Landslide I —N/A Floor Suite No
a,9 15 E�—
Description of Work �P`e
Use F—Const Type
# Stories #Units (if Res)
rqC
t
Valuation $ L/New/Add
Material/LaborItg l, 0v0
I
SFF— Remodel SF Ass1 F7Garage/New/Add
F—
OWNER'S NAME Last d 5
First I &C"b I?
Owner's Address
Owner's E-mail Address
13636 $lvd `yY8
—
F rd rSY I.Pe & ylMa.l. cd"
City 5 kW%OJA 0 A / ( State Fc-09//
Zip Telephone $ Ir b — 73I 73G
I O /
APPLICANT'S NAME Last So Fts
J
First �Vrdd Lf
I
Applicant's Address
Applicant's E-mail Address
I a35 S C-1eti S�V,ce4
t%$J_Vudtbt1 I
City S�Z, fn' State I C,4 —
Zip Ia7o7 Telephone,7/y�SJ-S_77
O
ARCHITECT/DESIGNER'S NAME Last First/ Lic. No. F
Architect/Designer's Address
Architect/Designer's E-mail Address
City I State F_
Zip F_ Telephoned
ENGINEER'S NAME Last
First I — Lic. NJ —
Engineer's Address
Engineer's E-mail Address
City I State F_
Zip F_ Telephone( --
CONTRACTOR'S NAME/COMPANY V 6 I _ C Lic No. q 71 ;Iy y Class
1�V 1
Contractors Address
Contractor's E-mail Address
SKI S. S��dLr,,f IMP
cad S!roc/'v�t`Ie
City �►-eu�S� State �—
Zip �) 96Y Telephone 7` rj 756,E
SETBACKS REAR SETBACKS FRONT
PERMIT NO,
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.t: ty'j117. "]i
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES S