HomeMy WebLinkAboutXR2023-2963 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application 01,wP0�Comm'I j- Residential City of Newport Beach - Building DivisionaNOTE: PI AN CHr PPPc nl IG AT IM11 �
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r Building r Grading rDrainage r Elec r Mech i�
r Plum Cu Yd Cutl Cu Yd Fill
Project Address (Not mailing address) f Flood r Fire F_ Liq r Landslide F_N/A Floor
Suite—Nc
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Description of Work
Use I— Const Type
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# Stories? # Units (if Res)F—
Valuations
Material/Labor
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New/Add SFF— Remodel SF �— Garage/New/Add �—
OWNER'S NAME Last (�.- /rl f,.r% First ,%o ,/Al
Owner's Address
Owners E-mail Address POD
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City NP s�/ln,n j / S
State ; —�—
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Telephone—
APPLICANT'S NAME Last reel .r'��o./.� First
Applicant's Address
Applicant's E-mail Address
City N, ✓Q�Ai f State Zip 7ZT j' Telephone -7,y- 7y
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ARCHITECT/DESIGNER'S NAME Last fJrir7 First
Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City I N n✓�o A? pJ r'Hr N State q Zip Telephone yyq �7
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ENGINEER'S NAME Last First I —Lic. No.F—
Engineer's Address Engineer's E-mail Address
City I State F— Zip F— TelephoneF�
CONTRACTOR'S NAME/COMPANY G'����•� / j Lic. No. 7,, goJo Class�—
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Contractor's Address
Contractor's E-mail Address
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City State ! �—
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SETBACKS REAR SETBACKS FRONT PERMIT NO. �,iJ-4v%
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE __ DEVELOPMENT Nn 11 A.I — 11 ____