HomeMy WebLinkAboutXR2024-0720 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application top
Comm'I �z Residential City of Newport Beach -Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL ow
rBuilding F_Grading F-Drainage f-Elec rMech F-Plum CuvdCut F CuYdFill F
Project Address (Not mailing address) F_ Flood r Fire F_ Liq r Landslide F_N/A Floor Suite No
F F
d 3v rnn7i2_nrnG e?4pqyan e-O&k er4 9a6as-
Description of Work
Use F Const Type F
C 65 it G RGv ozy,Z
# Stories # Units (if Res)F_
\ .b
Valuation $
Material/Laborer K
New/Add SF F__ Remodel SF arage/New/Add
OWNER'S NAME Last First G WA 16 e f(-z-g-
r
Owner's Address Owner's E-mail Address
d3v - /YL67Z✓ll /lifer cA-0 Jbn
City 1 C -D State G)q Zip /d/o;� Telephone
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
City �— State F_ Zip F_ Telephoned
ARCHITECT/DESIGNER'S NAME Last �— First Lic. No.
ArchitecUDesigner's Address Architect/Designer's E-mail Address
City State F_ Zip F__ Telephoned
ENGINEER'S NAME Last First 7— Lit. No.F
Engineer's Address Engineer's E-mail Address
City � State F_ Zip F— Telephoned
CONTRACTOR'S NAME/COMPANY 571 nri A Lic No. 9�+j JJt, Class
Contractor's Address Contractor's E-mail Address
Zld1 -3 S _;7: s 1 n n��v, Gv.n
City n -a.State G� Zip 9aLG3 Telephone�LJQ/-3a�-�3��
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK N .
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $