HomeMy WebLinkAboutXR2024-5214 - Permit ApplicationPrint Form 1 Worksheet for Combo Building & Solar Permit Application
r Comm] j— Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F-Building r Grading rDrainage F Elec F_ Mach r- Plum Cu vd Cut Cu Yd Fill s
Project Address (Not mailing address) F_ Flood r Fire r Liq r Landslide I -N/A Floor Suite No
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Description of Work
Use s ConstType s
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# Storiess # Units (if Res)s
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Valuation $
New/Add SFRemodel SFs Garage/New/Add
Material/Labor
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OWNER'S NAME Last F7>o/4,7 g - y First �yJ,cf fK
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Owner's Address Owner's E-mail Address
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City �qU�e/� � State AA Zip c , 443 Telephone
APPLICANT'S NAME Last First
First
Applicant's Address ��TV V \ �_� Applicant's E-mail Address
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—ate
City St F Zip F_ Telephoned
ARCHITECT/DESIGNER'S NAME Last FirstF Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State F__ Zip �— Telephoned
ENGINEER'S NAME Last First �— Lit. NoF
Engineer's Address Engineers E-mail Address
City State Zip �— TelephoneF—
CONTRACTOR'S NAME/COMPANY Gr $ (g�ilt/�fi !NL Lic. No. 3!lYUYS' Class
Contractor's Address Contractor's E-mail Address
city State e'� Zip f �Do Telephone 7/y S,sd
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SETBACKS REAR SETBACKS FRONT PERMIT NO. V,-7- 7-CZ_SZ - S Z k C4
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. C?-nd/
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $