HomeMy WebLinkAboutXR2024-0679 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application
It Comm'I r Residential City of Newport Beach - Building Division
NOTE. PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Description of Work
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# StoriesF # Units (if Res)
Valuation $ y //
Material/Labors * 4- F
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New/Add SF�— Remodel SF�— Garage/New/Add —
OWNER'S NAME
Last—
First C(,IRof-4-(�
Owner's Address
Owner's E-mail Address
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APPLICANT'S NAME
Last
First
Applicant's Address
Applicant's E-mail Address
City I—
State F_
Zip F— TelephoneF—
ARCHITECT/DESIGNER'S NAME Last
First 7—Lic. No. F_
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
City I
State �—
Zip I TelephoneF_
ENGINEER'S NAME
Last
First Lic. No.F—
Engineer's Address
Engineers E-mail Address
City
State F_
Zip TelephoneF_
CONTRACTOR'S NAME/COMPANY
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Contractor's Address
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Contractor's E-mail Address
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SETBACKS REAR
SETBACKS FRONT
PERMITNO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO. ` „® °° S
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $