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HomeMy WebLinkAboutXR2024-0750 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL F-Building i- Grading F-Drainage r Elec r Mech r Plum cuYdCut F cuvdHI F Project Address (Not mailing address) F_ Flood Fire r Liq r Landslide F_N/A Floor Suite No Description of Work/ 3 Use F_ Const Type s- 1 t J # Stories # Units (if Res)F_ Valuation $ i oo c> Material/Labor �rJ New/Add SFRemodel SF 2.1WO Garage/New/AddI-T % — OWNER'S NAME Last 12 1L V First Owner's Address Owner's E-mail Address � u -0 7-6 -- 6(Uq__ram Tv-h CityState F__ Zip Telephone APPLICANT'S NAME Last �CA` First v Applicant's Address Applicant's E-mail Address 2'7 i � (-e Ll C�R�P, tofu - L City lvG t�/l State h - -- Zip ?2a Telephone - ?/�4-6 W,/ 3�- 9 �T' [ ARCHITECT/DESIGNER'S NAME Last _ � /x_:, S � 0 rf(/ ©S First � Lic. No. r— Architeecct/Designer's Address Architect/Designer's E-mail Address / n (D� -q�1 (0 6, `,CtcC�i � zQfC^E�#� City �vC�p i C2 State Zip l �y� Telephone �/ �L%3 U /7 ENGINEER'S NAME Last ��� C C First Lic. NoF Engineer's Address Engineer's E-mail Address - 1 f City & �/V State CI Zip Telephone 9'7%i CONTRACTOR'S NAME/COMPANY Pryv�W��G cS Lic. No. $�5 0 Class Contractors Address Contractor's E-mail Address w c // r� City JR-K✓-C^�1�"t-cNT State �— Zip -�/2� 7 Z Telephone- l q 7 V SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO �j,.�, �j� ^,^/ PLAN CHECK FEES $ rC-GNC'C`VDUt'J