HomeMy WebLinkAboutXR2024-5459 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application oF�
Comm] esidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAI 5,._n,
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Description of Work�L-iy;
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# StoriesFT # Units (if Res)
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Valuation $
Material/Labor
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New/Add SF�— er SF �f11J �W Garage/New/Add �—
OWNER'S NAME Gt�fC:- �/L(i'r'/L�/l i(Ph�(/ ji •Fiat
Owner's Address
Owner's E-mail Address
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APPLICANT'S NAME Last jLt-"etX
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Applicant's Address
Applicant's E-mail Address
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City L y6i 'x'A l'�C 4iC' State
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ARCHITECT/DESIGNER'S NAME
Last 1_2-,li/✓6'if'1z—/
First R/Z;i-)y LicN
Architect/Designer's Address
Architect/Designer's E-mail Address
City State
Zip TelephoneF_
ENGINEER'S NAME Last �—
First F__— Lic. No.1
Engineer's Address
Engineer's E-mail Address
City � State F_—
Zip F— Telephoned
CONTRACTOR'S NAME/COMPANY K) i`k)O `& C q,6\ C c�,_nk, Lic. No. 50� ZZI J--CIass�
Contractor's Address
Contractor's E-mail Address
City Slate �—
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Zip �— TelephoneI y 11F S 1 CL{
SETBACKS REAR SETBACKS FRONT
PERMIT NO. C7
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $