HomeMy WebLinkAboutPV2024-0107 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application oF�E °°Rra
Comm'I r Residential City of Newport Beach -Building Division a_'
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL G.,.�"
rBuilding r Grading rDrainage F_ Elec r Mech
r Plum CuvdCut F CuvdFill F
Project Address (Not mailing address) F_ Flood
r Fire r Liq r Landslide F_N/A Floor Suite No
Spa 4 voot),,io v-e-,
CDC % �—
Description of Work
Use F—Const Type
# Stories # Units (if Res)F_
i L� VJ 1' v n
valuation $
New/Add SF� Remodel SFF_ Garage/New/Add F—
Material/Labor �6 970
OWNER'S NAME Last�Q��, ^ t
I�1�^
First
Owner's Address
Owners E-mail Address
'("„aid1l)OfNI�.
City State F
zip Tele hon C
APPLICANT'S NAME Last M� �
First 10-ile"A
Applicant's Address
Applicant's E-mail Address
City [(]����„E�7 State —
Zip 7: 6� Telephone 7/'Y 7%.S�,3�jj
ARCHITECT/DESIGNER'S NAME Last
First I
Lic No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City State �—
Zip F TelephoneF
ENGINEER'S NAME Last
First Lic. No.r—
Engineer's Address
Engineer's E-mail Address
City � State F—
Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY QL t
Lic. No. b' d i</ Class
Contractors Address
Contractors E-mail Address
6-�CLa7C=(� �C.�1LXyC�7�-/w`�L.L'C%
City State
Zip �.Z�US Telep/hone 7/Y—�
14 „ 0 %
SETBACKS REAR SETBACKS FRONT
PERMIT NO. ?V ZOZ`i - 0 10
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. PG2pZy -0'1 %y
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $