HomeMy WebLinkAboutPV2024-0129 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
(- Comm'I r Residential
City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding F_Grading rDrainage rElec j-Mech F-Plum CuvdCut F CuvdFill F
Project Address (Not mailing address) i- Flood r Fire r Liq I- Landslide FN/A Floor Suite No
3) 2 (,a C, N Q vi Gk) °12,�e3 �— 1
Description of Work
Use F Const Type
(-,)Cl
( i At V
# StoriesF # Units (if Res)F
Valuation $
Material/Labor
New/Add SFF Remodel SFF— Garage/New/Add
OWNER'S NAME Last S (rn S First
Owner's Address Owner's E-mail Address
City N U f State F Zip Telephone 44q 3 If
V
APPLICANT'S NAME Last -7 First �l
Applicant's Address Applicant's E-mail Addre
) 9 32 kv) F 0\ � � c f
City O J Y ` State I � Y 1 Zip � J � Telephone � � � �� v 0
ARCHITECT/DESIGNER'S NAME) Last First Lic. No. F—
Architect/Designer's Address 2,� ti - C % 6 { - ArchitecUDesigner's E-mail Address
City State F Zip F Telephone
ENGINEER'S NAME Last First Lic. No.
Engineers Address Engineer's E-mail Address
City State �— Zip F Telephoned
CONTRACTOR'S NAME/COMPANY O�tnn ` ' ` Lic- No. 5C Class Ch
Contractor's Address Contractor's E-ma' Address
City tv,1 / 1 State Zip % Telephoned(M, _
V U 1 l
SETBACKS REAR SETBACKS FRONT PERMIT NO. P, /26� 1 - ao/� 9
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SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. y�' 202� -Q j l l
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $