HomeMy WebLinkAboutXC2024-0304 - Permit ApplicationPrint Form Worksheet for Combo Building &Solar Permit Application oE °tea
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City of Newport Beach - Building Division
Comm'I Residential G NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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F_BuildingF_ Grading F-Drainage F_Elec rMech
F- Plum Cu vd Cuts Cu vd rills
Project Address (Not mailing address) r Flood
i— Fire F_ Liq i— Landslide F_N/A Floor Suite No
761 Vr'
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Description of Work
Use s ConstType s
I n oo
# Stories # Units (if Res)[_
Valuation $ F3AOO
Material/Labor
New/Add SF� Remodel SF�— Garage/New/Add �—
OWNER'S NAME Last Lic First
Owner's Address
Owner's E-mail Address
1701 V,,, � O S--dd
City R State F
Zip 3 Telephone 3 ,
APPLICANT'S NAME Last . 5
First
Applicant's Address
Applicant's E-mail Address
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k A Fc'C--rl � C�A = i Cri 1 1
City State G Zip Telephone Ci�
Mrr
ARCHITECT/DESIGNER'S NAME Last
First Lic. No.F_
Architect/Designer's Address
Arch itect/Designer's E-mail Address
City � State F_
Zip F TelephoneF—
ENGINEER'S NAME Last 50 �
First r � f r� Lic. No. �6v3_
Engineer's Address
Engineer's E-mail Address
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6 r , �%
City ^rI State �l/j Zip I�n-1,�/
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CONTRACTOR'S NAME/COMPANY
Lic. No. Class
Contractor's Address
Contractor's E-mail Address
City I State �—
Zip F__ TelephoneF_
SETBACKS REAR SETBACKS FRONT
PERMIT NO. xC. Z0Z — O 30
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. f 66 14 1773
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $