HomeMy WebLinkAboutXR2024-0503 - Permit ApplicationPrint Form Worksheet for Come Building & Solar permit Application
FL,Comm'I r �dential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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�rV4uilding F_ Grading F Drainage F_ Elec F_ Mech
r Plum CuYdCut rCuYdFill
Project Address (Not mailing address) F_ Flood
j` Fire F_ Liq (— Landslide FN/A Floor Suite No
Description of Work � jz ti /z.�> l r lv
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Use, Const Type V
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# Storiesro_—# Units (if Res)r� r
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Valuation$
Material/Labor 2
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New/Add SFr— I SF 7 Garage/New/Add I
OWNER'S NAME
Owner's Address IC AG
Owner's E-mail Address
City �lZv/yt/! _ State F(
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Zip Telephone
APPLICANT'S NAME Last 1-7 2' �; 7d
First J'/Y
Applicant's Address
Applicant's E-mail Address
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City ���NL/�x7� CAWD State I :' A
Zip Telephone
ARCHITECT/DESIGNER'S NAME Last First �� —2Z—
/a- P Q(Lic. N `�
Architect/Designees Address
ArchitecUDesigner's E-mail Address
City
Zip Telephone
ENGINEER'S NAME Last
First F_ Lic. NoF
Engineers Address
Engineer's E-mail Address
City State
Zip �� Telephone
CONTRACTOR'S NAME/COMPANY
Lic No. Class
Contractor's Address
Contractor's E-mail Address
City State F_
Zip F_ Telephoned
SETBACKS REAR SETBACKS FRONT
PERMIT NO. i'� v - Wit., w •\'k^
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $