HomeMy WebLinkAboutPV2024-0039 - Permit ApplicationPrint Form
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I Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division
Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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F-Building rGrading F-Drainage F_Elec FMech F'Plum CuYdCut CuYdFill
Project Address (Not mailing address) F_ Flood r Fire r Liq r Landslide i-N/A Floor Suite No
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Description of Work
Use I— ConstType �—
# Stories # Units (if Res)[—
Val $ 2
Material/,Laaboor -1 �l C
New/Add SF Remodel SF � Garage/New/Add �-
OWNER'S NAME LastFirstl
Owner's Add,A,dr``ess,, Owner's E-mail Address
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City txt,,_ State Telepho e�\'
APPLICANT'S NAME Lasty� First j
Applicant's Address Applicant's E-mail Address
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City C �,j c lau..,1.. State Zip I e,eN Telephoned
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ARCHITECT/DESIGNER'S NAME Last First F Lic. No.
Architect/Designer's Address ArchitectlDesigner's E-mail Address
City State Zip Telephoned
ENGINEER'S NAME Last �� First i Lic. No.F --4
Engineer's Address Engineer's E-mail Address
City �--_� State F_ Zip F_ Telephoned---
CONTRACTOR'S NAME/COMPANY �`i�1 '— , ._ /� tlCV Lic No. �0��[�O?ClassIr
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4 T� D� �xContractor's
Contractors Address E-mail Address
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City �r+ fl-u� State C [� Zip Gl Telephone q-fg6 Co
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SETBACKS REARSETBACKS FRONT PERMIT NO. ,1
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $