HomeMy WebLinkAboutXR2024-5547 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application (,I,
)a�rr Comm'I (— Residential City of Newport Beach - Building Division hNOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTALa.r"
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rDrainage r Elec r Mech KPIUM CuvdCut s CuYdHI l
Project Address (Not mailing address) F_ Flood r Fire j- Liq r— Landslide rN/A Floor Suite No
Description of Work
Use s ConstType s
#Stories #Units (if Res)s
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Cam! � � C C cv w-
Valuation $
Material/Labor F55 0(90
New/Add SFF
Remodel SFF-- Garage/New/Add F_
OWNER'S NAME
Last sC(t�f�tf First _5 % e,
Owner's Address
Owner's E-mail Address
City /1; q
m4.r State Zip Telephone 45k "M_G
APPLICANT'S NAME
Last r�OpL First
Applicant's Address
Applicant's E-mail Address
LL
City C f�
State Zip �aUTelephone 71 �6 2 S-S-
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City I
State �— Zip Telephone)
ENGINEER'S NAME
Last First 7 Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City
State F___ Zip F— TelephoneF_
CONTRACTOR'S NAME/COMPANY (�� y �oA Lic. No. gZygZO Class
Contractor's Address
Contractor's E-mail Address
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City \ ct��
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State /1 Zip Telephone �'�_ Oiz�
SETBACKS REAR
SETBACKS FRONT PERMIT PERMIT NO. XC—/07 %4 — 575-q
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $