HomeMy WebLinkAboutXR2024-5001 - Permit ApplicationPrint Form__ I Worksheet for Combo Building & Solar Permit Application
Fr Comm'I rT.Residential City of Newport Beach - Building Division t
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
GBuilding rGrading rDrainage rElec rMech F- Plum cuYdCut l cuYdFill
Project Address (Not mailing address) r Flood j- Fire F_ Liq r Landslide FN/A Floor Suite No
Description of Work /L'1 h lr1 /d' /L -'I- 21s����A /cf�G
Use Z 2/L; Const Type
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# Stories w # Units (if Res) ��
n
AA.'a%.
Valuation $ //
Material/Labboor / j rC Z
New/AddSF�! Rsmo$T5F f�h f' Garage/New/Add F
OWNER'S NAME/CAL �� �ni�/7/1�y-First
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Owner's Address Owner's E-mail/Address
City /� i ' 2r �' State A Zi � / __ J
p / Telephone 7Z Zr
APPLICANT'S NAME Last -7-�Z First %] y
Applicant's Address Applicant's E-mail Address
City I�//7 pfi ; /� State �J1 Zi Z
/ � p �' L Telephone / / %
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ARCHITECT/DESIGNER'S NAME Last Z y(j f
/ ��'i�iZ-/ First �Zi1/v��� Lic.N '_``%_Z`��
Architect/Designees Address Architect/Designer's E-mail Address
J.a >t14, A S l�/ j 67 .,
—________--a �— CityZip I"" Telephone�—
ENGINEER'S NAME Last �— First F_ Lic. NoT
Engineer's Address Engineer's E-mail Address
City I— State �— Zip �— Telephoned
CONTRACTOR'S NAME/COMPANY Lic. No. F_— Class F
Contractor's Address Contractors E-mail Address
City State �— Zip F— Telephoned
SETBACKS REAR SETBACKS FRONT PERMIT NO.IF C -' t
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $