HomeMy WebLinkAboutPV2024-0126 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application ("go'NF- Comm'I f- Residential City of Newport Beach - Building DivisionrNOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F_Building F- Grading
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F-Drainage r-Elec F_Meth r Plum CuYdCut F CuYdFill
Project Address (Not mailing address) F- Flood F- Fire F Liq F- Landslide F-N/A Floor Suite No
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Description of Work
Use ConstType F
F_oO-F Cv0.
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# StoriesF # Units (if Res)F_
#�ieS
Valuation $
Material/LaborFo)Vco
New/Add SFF—
Remodel SFF—Garage/New/Add
OWNER'S NAME
Last L A ✓\ 5 �. . Y' _ First S{ C.C�r( �
Owner's Address
Owner's E-mail Address
L,', Ao
Segwi 8s Pf,
City
State Zip F— TelephoneF—
APPLICANT'S NAME
Last First SC--:S y
Applicant's Address
Applicant's E-mail Address
City I
State F_ Zip F TelephoneF_
ARCH ITECT/DESIGNER'S NAME
Last First I Lic. No. �—
Architect/Designer's Address
Architect/Designer's E-mail Address
City I
State I Zip F Telephonel—
ENGINEER'S NAME
Last First I Lic. No.F—
9�
En meer's Address
7 � 1
Engineer's E-mail Address / t� � J
City
—
State F Zip I TelephoneF
CONTRACTOR'S NAME/COMPANY C� �A �" I C Lic. No. "� , t I J Class
JJ (Contractor's
Contractors Address
E-mail Address
City
State F— Zip F_ Telephoned
SETBACKS REAR
SETBACKS FRONT PERMIT NO. I?�r_Z1UI - CAI G l
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. �C
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $