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HomeMy WebLinkAboutPV2024-0091 - Permit ApplicationPrint Form_
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Worksheet for Combo Building & Solar Permit Application
Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
IBuilding rGrading
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rDrainage /Flee rMech FPlum CuvdCut cuvdFill
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Project Address (Not mailing address) F_ Flood r Fire r Liq r Landslide f N/A Floor Suite No
Description of Work
Use F—Const Type
ME-
Mnuo
#Stories #Units (if Res) F
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e , , � '/ �1n L�
(� C_ 1'I T
Valuation $ �pNew/Add
Material/Labor11�/
SF�—
Remodel SFGarage/New/Add
OWNER'SNAME
Last �n First
1
Owwn'er'r's Address
Owners E-mail Address
1`T
FTVCity
State �— Zip Telephone 1 1
APPLICANT'S NAME
LastFirst
Applicant's Address
Applicant's E-mail Address
Y) . a(l)e -� C
City
State �— Zip I elephone � f
ARCHITECT/DESIGNER'S NAME
Last (/� First F_ Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City ►(�'I/,tiln
Y�
State F,I(i/ ZipF1E1/_S Telephoned—t--
ENGINEER'S NAME
Last No ��p�n First � Lic. No /Aw _/ e—,�m
`aJ��l/V t
Engineers Address
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Engineer's E-�mJJlaiilllAddress
City t rv) q Q
State �— Zip 1 TelephoneRW�/6 jy
CONTRACTOR'S NAME/COMPANYI
Lic. No. 1���(�lassF
Contractors Address
Contractor's E-mail Address
City
State F_ Zip i— Telephone F_
SETBACKS REAR
SETBACKS FRONT PERMIT NO. 1 • = ?. Y -oO k
SETBACKS LEFT
!
SETBACKS RIGHT PLAN CHECK NO.pC !;y.0'j j6
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES S