HomeMy WebLinkAboutXR2023-3347 - Permit ApplicationPrint Form I Work§heet for Combo Branding & Solar Permit Application
( Comm'I i- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL'
F-Building r Grading FDrainage F- Elec F_ Mech
Plum CuYdCut F CuYdFill F
Project Address (Plot mailing address) (- Flood
F_ Fire F_ Liq F_ Landslide Floor Suite No
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Description of Work
Use Const Type
# StoriesF #Units (if Res)
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Vi tCt49 cA G L Iti-{--s 0'-A l s 4 $�
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Valuation $
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New/Add SF �— Remodel SF Q Garage/New/Add �—
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Material/Labor
OWNER'S NAME Last nn G� First
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Owner's Address
Owners E-mail Address
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City �v r4 1 ta _ 1 State F G.t
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Zip '(L 0 Telephone �� 9 it �
APPLICANT'S NAME Last
First tAk 4
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Applicant's Address
Applicant's E-mail Address
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City V� �"YS State C�
Zip y I ua Telephone � —vm -0 C rl S
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ARCHITECT/DESIGNER'S NAME Last �—
First F_ Lic. No.
Architect/Designer's Address
ArchitecUDesigner's E-mail Address
City State F_
Zip F_Telephone�—
ENGINEER'S NAME Last I
First F Lic No f
Engineers Address
Engineer's E-mail Address
City State F_
Zip F— TelephoneF—
CONTRACTOR'S NAME/COMPANY l�2 +"-JL Lic No. d (ayq(j&ClassFf3
Contractor's Address
Contractor's E-mail Address W*56
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City U t State �-
Zip y , y, (� Telephone j/�([_ c//Z (_ �a JJ
SETBACKS REAR SETBACKS FRONT
PERMIT NO. X- O I `d" Y i
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. ?
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $