HomeMy WebLinkAboutXR2024-1098 - Permit ApplicationPrint Form_ Worksheet for Combo Building & Solar Permit Application
F_ Comm'I F- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building r Grading
Project Address (No-
Description of
Work
1D jAtl1 a
�7.5�1h9 iZill/py1C2-
rDrainage F_ Elec F_Mech
r- Plum
Cu vd Cut
Cu Yd Fill F
mailing address) F_ Flood
r Fire j- Liq
r Landslide
F_N/A Floor
In I 1T
New/Add SFI 1 U— Remodel SF
OWNER'S NAME Last Lang)
Garage/New/Add I
FirstI �ath
Suite No
UseFR--)ConstType ff 6
# Storiess # Units (if ResF_
Valuation $ Fqj
�o/7 �)Material/Labor
Owner's Address Owner's E-mail Address
507 _Fw5tio /Ayenye jackl4mm?o oo-ayn
City NP i d /� 13PHLh State F Zip Telephone 1V 1- V -7,65
APPLICANTS NAME Last
Applicant's Address
City Tw�IC�VyjN State
First
Applicant's E-mail Address
b►'e1� @ ambtgyeq�d��1�1/yl�,tu>rl
Zip q�— Telephone 71"7l-g16
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address ArchitecUDesigner's E-mail Address
City State Zip I Telephone
ENGINEER'S NAME Last I!x
Engineer's Address
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City I �4)L Yhhn State r
First I J-aVhtS Lic. No.l a 15Y3
Engineers E-mail Address
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Zip gals l Telephone 7f y- V) Y V7
CONTRACTOR'SNAME/COMPANY pM`_'ynte n ),�4 Lic. No. JCt/I� Class
Contractor's Address
City j/, li * State G�
SETBACKS REAR SETBACKS FRONT
Contractor's E-mail Address
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Zip "la� Telephone 11y-v1-Y)4
PERMIT NO. I K ` LDM%4 W
SETBACKS LEFT SETBACKS RIGHT
USEZONE DEVELOPMENT NO
PLAN CHECK NO. n, LOZv1 m
PLAN CHECK FEES $