HomeMy WebLinkAboutU2024-5292 - 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
rBuilding I— Grading rbrainage r Elec r Mech
r Plum CuYdCut CuYdFill
Project Address (Not mailing address) F Flood
r Fire F Liq I— Landslide F_N/Af Floor Suite No
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& I �—
Description of Work
Use F—Const Type
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# Stories # Units (if Res)F
$CAI 1
3i`uAI-L-
Valuation $
Material/Labor ri
New/Add SFF_— Remodel SFF Garage/New/Add �—
OWNER'S NAME Last N
First Jo7
Owner's Address
Owners E-mail Address
City State F_—
Zip F— TelephoneF_
APPLICANT'S NAME Last 3(A1)1tAj
First
Applicant's Address
Applicant's E-mail Address
ly-) It ?Wh ?G CA 14W34
I&A,9 6EANEd.1r4
City I LpS aeUGr s State �—
Zip Clop3T Telephone 6�q-c/?0-�22Z
ARCHITECT/DESIGNER'S NAME �38
Last �N� First � ONJ Lic No. 3
Architect/Designer's Address
Architect/Designer's E-mail Address
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� EsQ L��- �
City }t q,_AAo6A KAC 4 State F;_
_
Zip g1025'{ Telephone 3(a-g}p- �5
ENGINEER'S NAME Last �&_V(40 6NGWy ¢sNti First— Lic.No.F
Engineer's Address
Engineer's E-mail Address
lSgo1__NAu�HvEn�l F:rrul�.------
Tu�c $�yUN�E/J�iaFe�T�vF.C_01�1
City I tA4jr/Dptp State FA-
Zip CjoTelephone 1 _2/0�
CONTRACTOR'S NAME/COMPANY J&T4W A ,!5-R)) &tCFWFCS 1tiL Lic. No. F Class
Contractor's Address
Contractor's E-mail Address
_1-5tO 2pD ACIF
City I COF-p,UA ,)bL MAe_ State F
zip I q2 67S Telephone gyq - Z33 -32Fo
SETBACKS REAR SETBACKS FRONT
PERMIT NO. UZdZy_ 'LQZ
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. E�ZUL'{ lq�Z
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $