HomeMy WebLinkAboutPV2024-0049 - Permit ApplicationPrint Form__ Worksheet for Combo Building & Solar Permit Application P
r Comm'I residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding rGrading F-Drainage rElec rMech
rPlum cuvdCut CuYdFill
Address (Not mailing address) r- Flood
r Fire r Liq r Landslide F_N/A Floor Suite No
(IProject
Description Work
Use F—Const Type
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# StoriesF_ # Units (if Res)F—
Valuation $
Material/Labor
New/Add SFF— Remodel SFF— Garage/New/Add F—
OWNER'SNAME Last Sd 1�,�
First C 4
Owner's Address
Owner's E-mail Address
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City njL��/ ;,/ PCaC- State
I "
Zipi�j �c Cj �Telephone[
APPLICANT'S NAME Last / \ 1e First wd
Applicant's Address
Applicant's E-mail Address
City 6C-,\dC,-, C�(ie
I,A e-5 (0 S�6 cv , "C- p « ,
State
Zip L Telephone
ARCHITECT//DESIGNER'S NAME Last
First Lic. No. �—
Architect/Designer's Address
Architect/Designer's E-mail Address
City I State �—
Zip F— Telephone
ENGINEER'S NAME Last �—
First 7— Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City � State F
Zip F Telephoned
CONTRACTOR'S NAME/COMPANY , _° o r (a Class C
`� �- Lic No.
Contractor's Address __ _ i'
Contractor's E-mail Address
tc;.(I
City hLil t✓ Cr State C f�
Zip ( C% Telephone P�i
SETBACKS REAR SETBACKS FRONT
PERMIT NO. 'Ps/2o7,L(_ 00t{Ci
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.ZOL�I -o3`d2
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $