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XC2024-0172 - Permit Application
Print Form Comm'I r Worksheet for Combo Building & Solar Permit Application Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Building r Grading rDrainage F_ Elec 'F<Mech r Plum Cu Yd Cut Cu Yd Fill F Project Address (Not mailing address) f- Flood [_ Fire F_ Liq r Landslide FN/A Floor Suite No 6 7 Gdv>nAll _&yLivl - v —S - Pb+) Paur EA" ck 9z6Gv �— r Description of Work Use F—ConstType Do-i1,t% #Stories If Units (if Res) r�7<n4vft- FAJ Valuation �Dt0P0 Material/Laa bor New/Add SF Remodel SF C� Gara e/New/AddF g OWNER'S NAME Last LL j% First g-IL,i✓ Owner's Address Owner's E-mail Address �S plI 1ZSC, d / PU 'l0�14 Y3 111 �)�V• LES1L$up :�Sfll �iL City --._Pnv,_ vim _ - _ -- _ _ _ State Zip �z 1 y Telephone q,3 633 5w_ APPLICANT'S NAME Last First Jwu Applicant's Address Applicant's E-mail Address r�3a oL_gL,, IL- ©W01j City I 10AyL_ArAt--�UWIState Zip I� Telephone 31# 63 d277 ARCHITECT/DESIGNER'S NAME Last Ck),r Vj First JDHN Lic. No. G7Il 1 6 a Architect/Designer's Address Architect/Designees E-mail Address - V33D % 1-1)0 'EF1_0N 62 M) f,/,W .6L-A,`, City 5 � (� t t- FV State C%54 Zip Telephone ,,J) p 463 6`2-7-? ENGINEER'S NAME Last First Lic. No.F Engineer's Address Engineer's E-mail Address City �— State I Zip 7_ Telephoned CONTRACTOR'S NAME/COMPANY Lic. No. F ClassF Contractor's Address Contractor's E-mail Address City I— State r_— Zip F_ Telephoned SETBACKS REAR SETBACKS FRONT PERMIT NO.X(t02,q -DI SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. �LZO2q► Q6�O USE ZONE DEVELOPMENT NO PLAN CHECK FEES $