HomeMy WebLinkAboutXR2024-0740 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application wPoR.
r Comm'I F_ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL 4,..0
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r'Building F_ Grading rDrainage r Elec r Mech j— plum CuvdCut F_ cuYdFill F—
Project Address (Not mailing
address) F_ Flood r Fire r Liq r Landslide i—N/A Floor Suite No
6 1���sAfAL)C,-t �
F_ [--
Description of Work
Use F—Const Type F—
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21=�^vJG f�KN`I k7AC &QI� W�L(,
# Stories # Units (if Res)r—
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Valuation a I SI 006
Material/Labor
New/Add SF �— Remodel SF Garage/New/Add
OWNER'S NAME Last
ALA NIFICI j INIr First qt
Owner's Address
Owner's E-mail Address
+v /_�1-FSSANoa-tA
City Rfr OE"
State („� Zip L�', TelephoneF—
APPLICANT'S NAME LastI
IJLI(J(j First J V N l.AeLo�
Applicant's Address
Applicant's E-mail Address
3fo% _10212M Icr
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City tOQ4M.1C-
State E Zip T0593 Telephone VI/- 331 6 4?
ARCHITECT/DESIGNER'S NAME
Last N�tTI D/i First
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Lic. No. I—
Architect/Designer's Address
Architect/Designer's E-mail Address
3,6 j S) 04o FBI A�13TiJP/� s . T I R� (�2 . (01
City �Q�R/�j �Lr�
State Zip l P Telephone 316 t716 55 38
ENGINEER'S NAME Last
r
1 � First C Lic No.��Q _
Engineer's Address
Engineer's E-mail Address
City
State �— Zip �— Telephone�—
CONTRACTOR'S NAME/COMPANY
&1 M � �l' , ^ Lic. No. �y� Class
'r I /
Contractor's Address
2-lz31 Av0,11"
Contractor's E-mail Address
Yov,) YN�eI�'�
City
IMF• y
State (iZip �2 Telephone��
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SETBACKS REAR
SETBACKS FRONT PERMIT NO. Xis ZG Zu --O U
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. PC_ ZGLLj —()5!cj y
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $