HomeMy WebLinkAboutXR2024-0653 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit App!/on o4
r Comm'I r Residential
City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
r.Building r Grading F-Drainage r Elec r Mech r Plum Cu vd Cut Cu Yd Fill s
Project Address (Not mailing address) r Flood F- Fire i- Liq i- Landslide i-N/A Floor Suite No
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Description of Work
Use F—Const Type s—
# Stories # Units (if Res)s
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Valuation $ 0�
Material/Labor
New/Add SF Remodel SF Garage/New/Add F_
OWNER'S NAME Last First L
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Owner's Address
Owner's E-mail Address
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City - -I- - $-� Q(1 - State - MJ Zip - Telephone
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
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City State
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1?- C! Zip Telephone�! f cr.
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ARCHITECT/DESIGNER'S NAME �^
Last--- r G First F Lic No. 3
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Architect/Designer's Address Architect/Designers E-mail Address
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city C Tdfi_P�11_(State -Cu Zip Telephone � ;49—SZCJO
ENGINEER'S NAME Last C Q first L �—
Lic. No, S I Z
Engineer's Address
9 Engineer's E-mail Address
City o - State Zip ��� Telephone�—
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CONTRACTOR'S NAME/COMPANY 4 ps /` / Lic. No. y// Q Shy Class
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Cont actor's Address Contractors E-mail Address
City �o State Zip L _(yd Sew Telephone
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SETBACKS REAR SETBACKS FRONT PERMIT NO. V?0-2 { -Q W j
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. ._ (� jZoj
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $