HomeMy WebLinkAboutPV2024-0089 - Permit ApplicationPrint Form 1 Worksheet for Combo Building & Solar Permit Application 019M
r Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF RI IRnnITTGI
F_Building F_Grading
(-Drainage F_Elec rMech F-Plum CuvdCut F_ CuydFill
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Project Address (Not mailing address) r Flood f Fire r Liq r Landslide rN/A Floor suite No
NCAL.v or-f- to3 F
Description of Work
Use F- Const Type
# Stor` . #Units (if Res)
J'
New/Add SFF—
Remodel SFF— Garage/New/Add F
$ - Valuation OC
Material/Labor t
OWNER'S NAME
Last First
Owner's Address
Owner's E-mail Address
City
State �— Zip F TelephoneF_
APPLICANT'S NAME
Last First o
K
Applicant's Address
Applicant's E-mail Address
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City I v eu5 i d e
State CA Zip lj2,50'j Telephone Ftf9X{e1( _ tt i
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ARCHITECT/DESIGNER'S NAME Last First Lic. No. �—
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State �— Zip F_— TelephoneF_
ENGINEER'S NAME
Last First F Lic. No.F_
Engineer's Address
Engineer's E-mail Address
City
State �— Zip �— TelephoneF—
CONTRACTOR'S NAME/COMPANY
44tv-1-64e6 .TCckno10v t�ecl,.,r. Lic. No. 9�y 1 5 Class L_ Ip
Contractors Address .'
Contractor's E-mail Address
34_L3 e-, CV-4r l
City
State FEk Zipq7 —3Telephone
I ,5 3 994)yg1- LlLVq
SETBACKS REAR
SETBACKS FRONT PERMIT NO.4-Lt&q- 00
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. � jjjJ t)�
USE ZONE
DEVELOPMENT NO0 1 4LJPLAN CHECK FEES $