HomeMy WebLinkAboutXC2023-0421 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application
W COMM] f Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not
r Flood r Fire r Liq r Landslide
216 F,/Lr-r �� sT -HwY. c°izo/k.1 D6L IgAe , C4
Description of Work
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New/Add S F I
OWNER'S NAME
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Owner's Address
2101 F }4J Gn4S7
Remodel SF F— Garage/New/Add r—
Last I c AfN First I rEJI) .
Cu Yd Fill
rN/A Floor
Suite No
Use F_ Const Type F
# Stories[— # Units (if Res)F—
Valuation $
Material/Labor
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Owner's E-mail Address
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City I CIPMW4 PEL MA12 State �—
ZIP Q 2 Zj'- Telephone �{� _44)192
APPLICANT'S NAME Last
Applicant's Address
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City I '_U l,i,e9-77y0
ARCHITECT/DESIGNER'S NAME
Architect/Designer's Address
City
State C4
First I '6up
Applicant's E-mail Address
BPf4SF' Y—t) F cLCeFRl6MATioa, 494
Zip IZ g j 5- Telephone % ' leq _r-6 Or
Last I First
Lic. No. F_
rArrchhiittect/D—esigner's E-mail Address
State F Zip Telephone[�
ENGINEER'S NAME Last P
First G �e,i Lic No. C 79 (yC]
Engineer's Address Engineer's E-mail Address
City State F_ Zip r--- Telephone
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CONTRACTOR'S NAME/COMPANY C 8 l � �i &I5( A ?) D 0 Lic. No. 3 � Y Class %�
Contractor's Address Am PIRAfC?Yd Contractor's E-mail Address
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City FU l.l�(z J 0 State —
Zip _g3 T Telephona[�) q p- 616
SETBACKS REAR
SETBACKS LEFT
SETBACKS FRONT
SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
PERMIT NO. XCZo23C)KZ f
PLAN CHECK NO. fl�Z.023..ZSKS
PLAN CHECK FEES $