HomeMy WebLinkAboutXR2024-1083 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar-P—e-mit Application c4sxY
F_ C omm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F_Building F_ Grading j—Drainage F Elec r Mech F— Plum cuvdCut F— CuVdFill F�
Project Address (Not mailing address) F_ Flood r Fire r Liq F_ Landslide F_N/A Floor Suite No
,Description of Work Use F- ConstTypeyF—
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# StoriesF / its (if Res)
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Valuation $
New/Add SFF— Remodel SF� Garage/New/Add �— Material/Labor j G1hC�
OWNER'S NAME Last `y'r 0 First Y.l(l roar I %&F eH AI/
Owner's Address Owner's E-mail Address
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CityFO�A QI^� State F � Zip _may Telephone
APPLICANT'S NAME Last 11 X/A Lo S v First 6 e_k,)A
Applicant's Address Applicant's E-mail Address
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City State �� Zip � L 5 Telephone `i
ARCHITECT/DESIGNER'S NAME Last First I— Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State F_— Zip F_— TelephoneF
ENGINEER'S NAME Last �f�= (� ( Z First I R p nEa7C Lic No.F —
Engineer's Address Engineer's E-mail Address
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City Ip A 0 � rG State M Zip C,F��(�' ��- , Telephone (414 qC(-,
CONTRACTOR'S NAME/COMPANY 1 1 n jq �����t ��� I `{ . Lic No. � (F—T4 ClassFB
Contractor's Address !,'� r "'' I Contractor's E-mail Address
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City O (a j of L State Zip 9'M 65 Telephone b [t )) zz;— 3 0 )
SETBACKS REAR SETBACKS FRONT PERMIT NO. xaZ07.4 • �Q g
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $