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HomeMy WebLinkAboutXC2024-0410 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application r5( Comm'I j- Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIMF OF SI IRMITTAI c.. RBuilding (Grading r-Drainage FElec r-Mech (-Plum Cu Yd CutF_ Cu Yd Filll Project Address (Not mailing address) i— Flood I- Fire r Liq r Landslide FN/A Floor Suite No q-7 4�- Description of Work Use F—Const Type F_ c>ClS i y1 CN C .1 # Stories # Units (if Res)F Valuation $ Q Material/Labor ZS, ©Q ��----- New/Add SF I I/I Remodel S �L'{) $jam Garage/New/Add �— OWNER'S NAME Last �-1Q lllkkk First Upc.IL-- % Ownelr/s Address Owner's E-mail Address \� City State L' Zip L(r' 6 TelephoneF— (Hirst APPLICANT'S NAME Last I1e Applicant's Address Applicant'slE-mail (/Address � y/ City State �- Zip qU40tq Telephone 4"v- ARCHITECT/DESIGNER'S NAME Last ��;1First f� V � Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address 77 - -7�,) wO� , G1 TDi)oN L&PN City y 1by Cj State 7'1 Zip C�t)Y(X_� Telephone _VJ - ENGINEER'S NAME Last /V a FirstFTJS Lic. No. F- Engineer's Address Engineer's E-mail Address 17_7 v� >M i V4 . City 4,wto 4116yli � C� State Zip (UL/( L/ TelephoneFTL'- (T,7 S CONTRACTOR'S NAME/COMPANY Lic. No. IU./ 1� t Class 71 _ r _ Contractor's Address Contractor's E-mail Address Z City I c l C �,, i a i State Zip `)Z,, 3 C Telephone e)y y. 3.; tI 3 SETBACKS REAR SETBACKS FRONT PERMIT NO. CZdZ7 - U y(O SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. QC20Z'4 USE ZONE DEVELOPMENT NO PLAN CHECK FEES $