HomeMy WebLinkAboutXR2024-5182 - Permit ApplicationPrint Form_ Worksheet for Combo Building & Solar Permit Application
r Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building r—Grading r—Drainage F_Elec rMech r—Plum Cu yd cut s— Cu yd FillF
Project Address (Not mailing address) Flood r Fire r Liq r Landslide f N/A Floor Suite No
Description of Work Use F—ConstType I
0
V `ter J C # Stories # Units (if Res)s
Valuation $
New/AddSFF RemodelSFF— Garage/New/Adds— Material/Labor FEA,00(0
OWNER'S NAME Lastl —I i eS First \-'V`;�I(,,,_�_
Owner's Address Owner's E-mail Address
city �� ��� State Imo' 1 Zip i' 2( /C Telephone 235 — 3Z�
APPLICANT'S NAME Lastl
�L�M �
Firstl
b"-v��
Applicant's Address
Applicant's E-mail Address
Nkuv, �� l
c s. ��
�� Z �jr..., ► , Go.- ,
City X /��..,r� /• C-C..1 S.� State I 1,
Zip _(Z S 77
Telephone /t/ / 3 7.S Ll6 S�
ARCHITECT/DESIGNER'S NAME
Last First—
Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
city I
State F_
Zip I
Telephoned
ENGINEER'S NAME Last 1` lvjS First L.ic. Lic No. S7GLJ(
Engineer's Address 1 Engineer's E-mail Address
Z l �{-SC.
City Lr V , State FT ' Zip 11 Z6 �'z Telephone C�
CONTRACTOR'S NAMEICOMPANY
Contractor's Address
City
SETBACKS REAR
SETBACKS LEFT
Lic No. F__ Class
Contractor's E-mail Address
State F___ Zip Telephone
SETBACKS FRONT PERMIT NO. X9207Q_ 5-t SZ
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $