HomeMy WebLinkAboutXR2023-2477 - Permit ApplicationI Print Form 1 Worksheet for Combo Building & Solar Permit Application N
F-Comm] i— Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OFRI IRMITTAI
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Project Address (Not mailing address) t— Flood F_ Fire r Liq r Landslide rN/A Floor Suite No
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Description of Work
Use F—Const Type
# Stories # Units (if Res)F
Valuation $
Material/Labor.000
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New/Add SF�— Remodel SFGarage/New/Add �
OWNER'S NAME Last ^f ( Gff �il, 57 First otE .V � � tJS
Owner's Address Owner's E-mail Address
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City �►�� ( State Vli� Zip Telephone 4/S
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APPLICANT'S NAME Last First �9r� %, e
Applicant's Address Applicant's E-mail Address
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City State I Telephone TO�, 5zzr:�2
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ARCHITECT/DESIGNER'S NAME Last �% First a::;Lic. No.n' �7
Architect/Designer's Address Architect/Designer's E-mail Address
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city FTT�fb�. r r✓ State Zip TelephoneF?!(q- (03 S ZC,0
ENGINEER'S NAME Last `7,5 First F__5__cyTT Lic. No. C- � 5 Tjpq
Engineer's Address Engineer's E-mail Address
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City CQ " State — Zip Telephone 7 1 Y. 5595. 2-SOO
CONTRACTOR'S NAMElCOMPANY ]0 W�j Lic. No. r Class F
Contractor's Address Contractor's E-mail Address
City State �— Zip F_ TelephoneF_
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ v