HomeMy WebLinkAboutXR2024-5328 - Permit ApplicationP"r!t Form Worksheet for Combo Building & Solar Permit Application OE jEW pq
r Comm'] F_ Residential City of Newport Beach - Building Division
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Project Address (Not mailing address) F Flood F_ Fire r- Liq (" Landslide f N/A Floor Suite No
Description of Work
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Use ConstType�
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# Stories # Units (if Res)s
New/Add SFr Remodel SF s-- g Gara a/New/Add F—
Valuation$
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OWNER'S NAME Last First
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Owner's Address -
3 Owner's E-mail Address
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City State
Zip TelephonePt -9321- v
APPLICANT'S NAME Last /2(/ 1't0?✓ First ��S•
Applicant's Address Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME
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Lit. No. F
ArchitecUDesigner's Address Architect/Designer's E-mail Address
city State �- Zip [-- Telephone[ --
ENGINEER'S NAME Last S {/e✓/ S First �/�f?-�(� LicNo. r5_a-79`-
Engineer's Address Engineer's E-mail Address
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City Dt,4']A- P IAJ State Zip - Telephone
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CONTRACTOR'S NAME/COMPANY �I s i7 ��.7 s
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Contractor's Address Contractor's E-mail Address
City State r7Fj- Zip G,30H j Telephoner-7/y-
SETBACKS REAR SETBACKS FRONT PERMIT NO. XVZ6LJ4
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. vV
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $