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XR2024-0163 - Permit Application
Print Form Worksheet for Combo Building & Solar Permit Application r°°Rr i- Comm'I residential City of Newport Beach - Building Division10 NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL ,,F-Building r Grading [-Drainage r Elec r Mech r Plum CuYdCut CuYdFill l Project Address (Not mailing address) fW Flood r Fire i- Liq r Landslide 1_N/A Floor Suite No Description of Work (LL U Use F—ConstType # Stories # Units (if Res)s Valuation$ New/AddSFF— Remodel S.FF—Garage/New/Adds— ScC� Material/Labor [� OWNER'S NAME Last V\�-CAI) First 1�� C� -K-, Owners Address Owner's E-mail Address S0-7 A-0-•'\J�Ci I'�v-- c a City �)eJ ;e,,CL, State Zip C5�'Lr. a Telephone T- CGk�" �kCk APPLICANT'S NAME Last First rV C,,"�A- Applicant's Address Applicant's E-mail Address S6_7 6kJ. -o , cL`0. _ Cif F-S�VL—©o :--, - o�- City ���.qdr State �- Zip Telephone LL�_"z�S- G( 1 ARCHITECT/DESIGNER'S NAME Last First F_ F Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address City State � jp TelephoneF ENGINEER'S NAME Last First F Lic. No.F_ Engineer's Address En i ail Address City State F— Zip Telephoner CONTRACTOR'S NAME/COMPANY Lic. No.lass Contractor's Address Contractor's E-mail Address City State F— Zip I Telephone SETBACKS REAR SETBACKS FRONT PERMIT NO. �i7i�Zv`� 110� SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.T 0,01- O\", s USE ZONE DEVELOPMENT NO PLAN CHECK FEES $