HomeMy WebLinkAboutXR2024-5451 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application qiz
WrVfomm'I QvAesidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL U
Building F_Grading
F-Drainage r-Elec F_Mech F-Plum Cu vd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood r Fire r/Liq r Landslide F_N/A Floor Suite No
�C�G /L��cv
✓Lj i�Lv>`%/ �%/C� L-���jlf1 2i!/C� �l>l�
Description of Work — �
Use�(,,Qonst Type �
I "
# Stories77 # Units (if Res)
(i i� Gt S f�iy'D
lG /tiL /A_1-;4 A> TG GZ >
New/Add SF
$QmeAe4-SF Z(�, � Gara a/New/Add
g F—
Valuation $ J n// �701
Material/Labor
OWNER'S NAME
f�eC
//�!i •IP,41LI7-
Owner's Address
Owner's E-mail Address
City fLj/ ih',1
State �i4 Zip ZT,%`% TelephoneF�j - 72c-
APPLICANT'S NAME
Last 7 /P--& f >r- First JA
Applicant's Address
Applicant's E-mail Address
City 1�21/1 L%;oA /ZZ t- A /✓/7 State �A Zip «- " L Telephone ' j
ARCHITECT/DESIGNER'S NAME Last %Z-l/v, First FAi'L'Dx Lic. No. i Of z-Z_y"
Architect/Designer's Address
Architect/Designers E-mail Address
SArvr� i�
/JL` a%
City F
tate Telephone
ENGINEER'S NAME
Last First Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City I
State F_ Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY Lic. No. F-- Class r—
Contractors Address
Contractor's E-mail Address
City
State F___ Zip F— Telephoner
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $