HomeMy WebLinkAboutPV2024-0043 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application Rxam4v/
r Coni r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FFFC ni IF or Tmnc nc c� iourr-rn
F_Building r-Grading r-Drainage
[_Elec FMech r Plum CuvdCut s CuvdFill
s
Project Address (Not mailing address) f Flood r Fire j _ Liq r Landslide rN/A Floor Suite No
Description of Work
Use s ConstType s
# Stories # Units (if Res)s
- -. 10
wtod
Valuation $
Material/Labor
New/Add SF Remodel
SFs--
Garage/New/Add �—
OWNER'S NAME Last �(�,r�
�ISi0. �-Y--First
Owner's Address
Owner's E-mail Address
1S1ic- .. J�°fYVrn Lv�U�
-
City Cunsavt? ncl� Ajj,,u— Y
- -
State —
c - ZiP 92W7- TelephoneF
APPLICANT'S NAME Last
First FTv,aLt'i 5
Applicant's Address
-
Applicant's E-mail Address
City �5!�„�
-
State Zip q2 � Tele hone-
Wh � P 9LF�t- l�-4t
ARCHITECT/DESIGNER'S NAME
Last - First F_
Lic. No. F—
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State �— Zip r— TelephoneF_
ENGINEER'S NAME Last
First F_ �—
Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State �— Zip [_ Telephones --
CONTRACTOR'S NAME/COMPANY
Lic. No. Clas
�s �j t�t�fi425'Sc� �1e^� qo5 S'1 b s
Contractor's Address
Contractor's E-mail Address
City
State F Zip F_ Telephones--
SETBACKS REAR
SETBACKS FRONT PERMIT NO.?V loM
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK Novc=y Q ?.91
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $