HomeMy WebLinkAboutXR2024-0300 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application Of
_� 9 ppr Comm'I ResidentialCity of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F_Building r-Grading F-Drainage F_Elec F-Mech
F-Plum CurdCut F CuydFill F
Project Address (Not mailing address) F_ Flood
r Fire r Liq r Landslide rN/A Floor Suite No
Description of Work
Use F Const Type
# Stories # Units (if Res)FE
Valuation $ .Z S.' oa
Material/Labor 7
New/Add SF� Remodel SFF Garage/New/Add �
OWNER'S NAME Last
First 30}1eH
Owner's Address
Owner's E-mail Address
1101 4� _ Cn�VELc DR
:T(D
City pA�S k�Elbt-N-CS State f L
Zip 6ayb3 Telephone g� i 3y3-��3y
APPLICANT'S NAME Last
First I G�-Oytz
Applicant's Address
Applicant's E-mail Address
2-aSJ FI:�t,.�Po22 cTVZ - D tL � t�-,32a-
(�E17R.6£ pY'^��S�.IZoS�Ut�nE25 , C-Ow�
City State F2�
Zip gid.klC] Telephone["'
ARCHITECT/DESIGNER'S NAME Last First �—
Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City I State F_
Zip I Telephoned
ENGINEER'S NAME Last
First F__ Lic. No.F_
Engineer's Address
Engineers E-mail Address
City State F__
Zip F— Telephoned
CONTRACTOR'S NAME/COMPANY h otJz O ��s ���+✓ I t1L , Lic No. LO � 14U3 Class
Contractors Address
Contractor's E-mail Address
weV40 C �z�oP. _ i\-3�- --
+'t"']CN��.�Mo4-l-tC.SWh\�aS.�vlL�c.Rsi_ C-O-,
City jj �_ State FE�W_
Zip `t- �-b'o Telephone �4�-035-}O�
SETBACKS REAR SETBACKS FRONT
PERMIT NO. Z®Z - Q
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. y
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $