HomeMy WebLinkAboutPV2024-0079 - Permit ApplicationPrint Form_ _ Worksheet for Combo Building & Solar Permit Application
Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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[Building Grading ['Drainage [Elec [Meth
[Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood
[ Fire r Liq r Landslide FN/A Floor Suite No
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Description of Work
Use s ConstType �—
# Stories# Units (if Res)s
o /
c f-c 5.r ^L hu m
_ham C �� �" [ 7�%
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1,
Valuation $
dd S Remodel SF F— Garage/New/Add
Material/Labor z t^ Coo
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OWNER'S NAME Last , p First J C>
Owner's Address
Owner's E-mail Address
2 101 C- F,, /,, e I j
Jw, r, � � �.c ,
City I , i` Q �^ \ State
Zip 9'21 C6 Telephone /6703 0
APPLICANT'S NAME Last r%1 5���
First e_— -_ S
Applicant's Address
Applicant's E-mail Address
34!;�o E r1 s 9
11,� U�5. eC, 5tr,.G
City FT-) State I ZT
Zip G(2 `7r/�J Telephone...--///. _ �1p-7 16p IC
ARCHITECT/DESIGNER'S NAME Last �—
First �— Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City State F—
Zip F— Telephonel—
ENGINEER'S NAME Last I t'%a,.r Iles
First %P� 411% Lic No. 2J
Engineer's Address
Engineer's E-mail Address
r� D b W I�
�
f Vtr.Jen IneerL,-c= , cw,/
City v C m1 'Ch State I T V
Zip g" O Telephone q S' - g 7 Z, v 7/
CONTRACTOR'SNAME(COMPANY r� ,l�
cN/e% �� /D� r 0,_? 5 Lic. No. 9 73"z Class
Contractor's Address
Contractor's E-mail Address
360 F ��5� S� -,e9 f //�-,
City sU S/ State I C
Zip `i Z% 6 Q Telephone 7�C�_ Z S g— 3 400
(-6, 30 --t 7 S l
SETBACKS REAR SETBACKS FRONT
PERMIT NO. V�Z qJ-1 -
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. p�QS%e,�
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $