HomeMy WebLinkAboutXR2024-0162 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application F
O`' B
F_ Comm'I F_ Residential City of Newport Beach -Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F_Building r Grading
F-Drainage T Elec r Mech Plum CuvdCut CuvdFill s
Project Address (Not mailing address) F_ Flood r Fire j- Liq r Landslide F_N/A Floor Suite No
F
Description of Work
Use F—Const Type
# Stories # Units (if Res)s
c.Jl D l>.> c7f
ov �N �a'6a1 Wing ,mac
Valuation $
New/Add SFF—
Remodel SF Ir Garage/New/Add F_
Material/Labor
OWNER'S NAME
Last First
Owner's Address
Owner's E-mail Address
City
State I Zip Telephones
APPLICANT'S NAME
Last First
Applicant's Address
Applicant's E-mail Address
City
State �- Zip F TelephoneF—
ARCHITECT/DESIGNER'S NAME Last First �, Lic. No. F_
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State F—Zip F TelephoneF
ENGINEER'S NAME
Last First Lic. NoT__
Engineer's Address
Engineer's E-mail Address
City
State Zip Telephone
CONTRACTOR'S NAME/COMPANY Lic. NO.FpSy34 Class
,CASv57
Contractor's Address
Contractor's E-mail Address `$T�pog31,32
('P D 1 f itlM�'3oGb 7-
1AW toApe • doo,
City *,64- 41�a� State I `-" - Zip pZ886 Telephone
SETBACKS REAR
SETBACKS FRONT PERMIT NO. XV C) Z4 —j- FjZ
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $