HomeMy WebLinkAboutXR2024-0436 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar permit Application ?T
F?_Comm'I C-4esidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
jj�uilding F_ Grading j-Drainage F_ Elec r Mach (- Plum CuydCut CuYdHI F
Project Address (Not mailing address) r- Flood r Fire r Liq F- Landslide FN/A Floor Suite No
Description of Work VIVA 7-e-/1- f- /2-1- 1,}%7e'v
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# Stories ;,/# Units (if ResiO
Valuation
Material/Labor
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New/Add SFF -- 6eu�ecFeYSF J Z Sf Garage/New/Add
OWNER'S NAME Last /�'-�//�(/� First
Owner's Address Owners E-mail Address
City State Zip F TelephoneF
APPLICANT'S NAME Last First J/t y
Applicant's Address Applicant's E-mail Address
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City /.t)A�G�(1A �SlRNJ State I C "' Zip 9�/p� Z Telephone,'y¢
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ARCHITECT/DESIGNER'S NAME Last A2/i �(�/ First �7 /y �� Lic. N �¢
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Architect/Designer's Address Architect/Designer's E-mail Address
City ip Telephone
ENGINEER'S NAME Last �— First F_ Lic. No.F
Engineers Address Engineer's E-mail Address
City-- State Zip �.. Telephone�—
CONTRACTOR'SNAME/COMPANY v�• � Lic. No. PC-lk.�lassF_
Contractor's Address Contractor's E-mail Address
c �,Icg m State l Sr � Zip R Z� Telephone)
City;nlL
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SETBACKS RlEARSETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK C•• (- _t 1-
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $