HomeMy WebLinkAboutXR2024-6904 - Permit Application�wZ
Print Form_ j Worksheet for Combo Building & Solar Permit Application
j7/Comm'I U�-ffesidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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r Plum CuYdCut F CuvdFill F
Project Address (Not mailing address) F_ Flood i— Fire r Liq r Landslide FWA Floor Suite No
Description of Work
Use ���Const Type
# Stories # Units (if Res)
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Valuation $
Material/Labor
New/Add SFF— eISF �%i�% Garage/New/Add—
OWNER'S NAME
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Owner's Address
Owner's E-mail Address
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City / ti State
Zip ZG /7 Telephone � - -72v �- -'(;F p
APPLICANT'S NAME Last 712-UAX
First J4�/
Applicant's Address
Applicant's E-mail Address
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City /,;�/14 /�i0� �� Lir.V� State ;I
ZipE'J1z Telephone 7 j '1,5� Sl�,J
ARCHITECT/DESIGNER'S NAME Last rZ/1 Z9 vim/°'./
First ]]�
�,6t�/� Lic. N �2Z
Architect/Designer's Address
Architect/Designer's E-mail Address
City ate
Zip F__ Telephoned
ENGINEER'S NAME Last
First F Lic. No.F__
Engineers Address
Engineer's E-mail Address
City State I
—
Zip F_ TelephoneF
CONTRACTOR'S NAME/COMPANY
Lic. No. F-- ClassF—
Contractor's Address
Contractor's E-mail Address
City I State F
Zip F TelephoneF
SETBACKS REAR SETBACKS FRONT
PERMIT NO. YGL20 1-�' VC q0
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $