HomeMy WebLinkAboutXR2024-6162 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F_ Comm'I j— Residential
City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F_ Building r Grading rDrainage r Elec r Mech r Plum CuvdCut F CuYdFill F
Project Address (Not mailing address) F_ Flood r Fire r Liq r Landslide rN/A Floor Suite No
Description of Work LC' rY--/� �✓ t�/�Y' /z,` a!z 4 77 E
UseF VoConst Type Ir '/ -
# Stories # U is i es
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Valuation $
Material/Labor � 7-�
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New/Add SF[ ,red' SF Z0% ,F Garage/New/Add
OWNER'S NAME Fl2 b i/1,,Z /%`L; /Lx y y ,�/
Owner's Address Owner's E-mail Address
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City /�T /(/_ State I ` A ZIp / % Telephone �¢e?- 7-zr- a ?e,
APPLICANT'S NAME Last "'/� x First 1 �J,9
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Applicant's Address Applicant's E-mail Address
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City �jl9L e.4 SLIart state F Zip %e4/VZ Telephone 9 •-`�vtj-�jdj`��
ARCHITECT/DESIGNER'S NAME Last �2ANJ / First �%;t,>v Lic No. Z�z25
Architect/Designer's Address Architect/Designer's E-mail Address
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City State F_Zip Telephone
ENGINEER'S NAME Last First F_ Lic. No.1—
Engineers Address Engineer's E-mail Address
City I State F_ Zip Telephoned
CONTRACTOR'S NAME/COMPANY Lic. No. F_ Class
Contractor's Address Contractor's E-mail Address
City State Zip �— Telephone�—
SETBACKS REAR SETBACKS FRONT PERMIT NO. y L.QI La2__
SETBACKSLEFT SETBACKS RIGHT PLAN CHECK O.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $