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HomeMy WebLinkAboutXR2024-0295 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application Comm'[City of Newport Beach - Building Division r r Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL G,o„ F_ Building r Grading j—Drainage r Elec F Mech r Plum cuvdCut cuvdFill F_ Project Address (Not mailing address) r— Flood r Fire f Liq r Landslide rN/A Floor Suite No 7�1 �,Z �- Description of Work Use F— ConstType p ' f> i�' 41V ..'I "•-�, �' � _ l # StoriesF_ # Units (if Res)F_ Valuation $ / Material/Labor k� l 61 Z r' New/Add SF F Remodel SF Garage/New/Add Ir OWNER'S NAME ,�1 Last �tXlY�jG ✓'� First L.6`e�_ Owner's Address Owner's E-mail Address �-tit'i^��\1u1�t.�n�>mi�s�Ct�a11(�!/ t Cen•�--� City N ,? ��� State C A Zip lq Z� � & & Telephone Ojq APPLICANT'S NAME Last Ceti — First FU-LJ Applicant's Address Applicant's E-mail Address ZLUt_I ( , Ay- vv. ct ©� �e.c,sN�.vt c�Ce.t lra�locs:co City 2dtite_. 41,v State (.Q Zip (T:?o Telephone i ARCHITECT/DESIGNER'S NAME Last Lic. No. First I �— Architect/Designer's Address Architect/Designer's E-mail Address City State F Zip F_ TelephoneF_ ENGINEER'S NAME Last First F_ Lic. No.F— Engineer's Address Engineer's E-mail Address City State F_— Zip �— Telephonal CONTRACTOR'S NAME/COMPANY 11 pp r- y Lic No. L4' i tlUt Lit"lull U}�1?kUIS I >C�L� Class J (1y(� Contractor's Address Contractor's E-mail Address City V'•-L..kA' � C C �'„tt � �� State �� Zip G�� Telephone L, SETBACKS REAR SETBACKS FRONT PERMIT NO.7V 2iaj—' J"5 SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $