HomeMy WebLinkAboutXR2024-0889 - Permit Application. Print Form J Worksheet for Combo Building & Solar Permit Application o4�EWPoRe
r Comm'I (- Residential
City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding r Grading F-Drainage rElec rMech
r Plum cuYdCut cuvdFill
Project Address (Not mailing address) r Flood
r Fire r Liq r Landslide F_N/A Floor Suite No
2 jn� CnxcPc..��ti 17c:v't �J2 p, E
cbtl C.�%Z�cC
Description of Work
Use s ConstType s
-€ �?�-r Z IOCr-Lic."�5 C u-.-lKw�- �•' � !ti
Sel-+ s p=-• S
# Storiess # Units (if Res)s
Valuation'
Material/Labor Zr
New/AddSFF_Remodel SFF-Garage/New/Addlr
OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
City State F_
Zip F— Telephone—
APPLICANT'S NAME Last ,\
First jetic,.,"
Applicant's Address
Applicant's E-mail Address
D'EC• r
City � rtc w. �; � State e A
Zip q ZZ Z .3 Telephone 9�I �rb-7 N K j
ARCHITECT/DESIGNER'S NAME Last Lic. No.
First F_ �—
I
Architect/Designer's Address
Architect/Designer's E-mail Address
City State F—
Zip F— Telephoned
ENGINEER'S NAME Last
First 7 Lic. No.F -
Engineer's Address
Engineer's E-mail Address
City State F_
Zip F— Telephones
CONTRACTOR'S NAME/COMPANY n o c�et
i Gc,r,i( r.l 5
L
J fJ% ,c,k Ccti iashr� ;,Lic. No. �� �s Z Class
Contractor's Address
Contractor's E-mail Address
L'`G�' Li, ty" 7�e f t t
k �`A BGZCL�AL, Cco
City ( 73_' (-` Gv}r S C�k State (G'L
Zip FL'2 Telephone Tj (�I
SETBACKS REAR SETBACKS FRONT
ynp zy
PERMIT NO. / tl t�2 L{'(JG 8,_i
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $