HomeMy WebLinkAboutXR2024-5511 - Permit ApplicationPrint Form _Worksheet for Combo Building & Solar Permit Application SP
City of Newport Beach - Building Division
r Comm'I (- Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
FBuilding F Grading r-Drainage r-Elec F_Mach(-
Plum CuvdCut F CuvdFill F
Project Address (Not mailing address) r Flood
r Fire r- Liq r- Landslide rN/A Floor Suite No
H-1-
Description of Work
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Use ConstType
#Stories # Units (if Res)
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Valuation $
Material/Labor
New/Add SF I— Remodel SF I Garage/New/Add
OWNER'S NAME Last ` r-CCL-MJ 1 First n f- � e
`r't C \ Cr
Owner's Address � - �� �
Owner's E-mail Address
c E CEO-
I ®SC �s fiCGov C-0V.
CityWe�_� !D� r I State C/�
Zip Telephoned 413 .- 311
APPLICANT'S NAME Last iflu Y
First
V
Applicant's Address
Applicant's E-mail Address
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City RL��L L1 State I CA
Zip 1' UU�r7 Telephone C q _G 3
l II lF_
ARCHITECT/DESIGNER'S NAME Last First � Lic. No.
Architect/Designer's Address
ArchitecttDesigner's E-mail Address
City I State F_
Zip F_ Telephoned
ENGINEER'S NAME Last (�� First �( t� G� Lcic. No.1
v`O
Engineer's Address
Engineers E-mail Address
City State F
Zip F TelephoneF
CONTRACTOR'S NAME/COMPANY I
`� L� (Z i 1
1 j
(�QY 0 S- f Lic No. �� i i �� Class
Contractor's Address
Contractors E-mail Address
9-3 S C
h
City �C,,V�& j VA State I L,4
Zip I c Telephone I `il q y -_3L93
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SETBACKS REAR SETBACKS FRONT
PERMIT NO. X 2 (�(llj�l — J•S I
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $