HomeMy WebLinkAboutPV2024-0070 - Permit Application_ Print Form ] Worksheet for Combo Building & Solar Permit Application
[- Comm] r esidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[-Building [-Grading [—Drainage rElec rMech
[-Plum CuvdCut F_ CuYdFill F_
Project Address (Not mailing
address) r Flood [- Fire [- Liq [- Landslide rN/A Floor Suite No
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Description of Work
Use F—Const Type
SO LA A)-R- l 1N 12T
#Stories #Units (if Res)
Valuation $
Material/Labor F/d 8
New/Add SFF— Remodel SF�— Garage/New/Add �—
OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
City
State �—
Zip F— TelephoneF—
APPLICANT'S NAME Last
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First 91�—I.fA
Applicant's Address
Applicant's E-mail Address
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et, VP
I IA N e CV.W&L-r-rN ' 9�>L.4 k.fi
City F05 Al -AM trvS
State I CA—
Zip TelephoneJ t_1_W 42q__ o y67
3
ARCHITECT/DESIGNER'S NAME
Last
First/ Lic. No. �—
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State �—
Zip Telephone
ENGINEER'S NAME Last
�—
First F_ Lic. No.�
Engineer's Address
Engineers E-mail Address
City �—
State f
Zip �— Telephoned—
CONTRACTOR'S NAME/COMPANY
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Lic. No. Class l /C
SD LA 1/C�Zr
Contractors Address
Contractor's E-mail Address
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Fh%ram A -.0GAS.
City I LOS4LAM M5
State ��
Zip oj0�-Zo Telephone `- / y'4ZZ-o y6g
If
SETBACKS REAR
SETBACKS FRONT
PERMIT NO. P V 2o2 -! — Oo 7O
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO. (XUL4.65ZI
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $