HomeMy WebLinkAboutXC2024-0075 - Permit ApplicationPrint Form
Comm'I r
Worksheet for Combo Building & Solar Permit Application
Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FFFR ni lF AT TinnF nG ci iQnA=ni
Building r- Grading r-Drainage r- Elec r Mech r Plum Cu Yd Cut r` Cu Yd Fill !
Project Address (Not mailing address) F Flood (— Fire r- Liq r Landslide FN/A�Flloor Suite No
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Description of Work
Use � Const Type �—
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' / A- S
# Storiesr— # Units (if Res)r—
Valuation 5 n
Material/Labor s
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 Telephoned
APPLICANT'S NAME Last
�ar� ��� First
Applicant's Address Applicant's E-mail Address
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City / h
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n 7a
State
I C Zip �i TelephoneI7 /y &7,71,w
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ARCHITECT/DESIGNER'S NAME
Last First F_ Lic. No. r-.--
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
City F �
State r— Zip �� Telephoner----'
ENGINEER'S NAME Last
First F_Lic. No. F---
Engineer's Address
Engineer's E-mail Address
city r------ i�
State F_ Zip F— Telephoner ---
CONTRACTOR'S NAME/COMPANY
n nG pAn Lic No.7i711 Class
16
Contractor's Address
Contractor's E-mail Address
Gdac/
City 16 1, 13G/
State C/— Zip 9aCVr Telephone`� -7�?7.7i�
SETBACKS REARUU
SETBACKS FRONT PERMIT NO. xlfZ0Zq - 0 ads
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. PCf6Zy_C '
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $