HomeMy WebLinkAboutXR2024-6479 - Permit ApplicationPrint Form j Worksheet for Combo Building & Solar Permit Application
t<omm'I /Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
j[j15'uilding j- Grading r-Drainage r- Elec r Mech r Plum CuvdCut CuYdFill F
Project Address (Not mailing address) F_ Flood r- Fire r- Liq F_ Landslide .r-N/A Floor Suite No
/GAG 7)0-//i6-L-ASe1sc%q(,;ti j�z Z5
Description of Work AV.4 -?2 �A7y+/t loll /� 4A7
Use TL -vjconstType
# StoriesrT,� # Units (if Res)
455�vT /�5i4w.
�-iLG�st/ �Al jT/L . /_ 4"S �� Q �
r�s Sr«�. /?n r-u.-rls
Valuation ��
Material/Laa bor �. �
New/Add SF� �4 f. F � J�% ��F Garage/New/Add
OWNER'S NAME
Owner's Address Owner's E-mail Address
3/
City FIA1lI/Uf, State `�fp�7 Telephone 7QD—
C/a Zip
APPLICANT'S NAME Last 17/Zv A 3C First v� v
-Applicant's Address Applicant's E-mail Address
-Zoo lz / /,;5A dti c A 1/iF- �z f cad (? o�tloQ .Cam
City /i,Z,? dx �C�fJ�y{JState I Zip 7 6bvz— Telephone
ARCHITECT/DESIGNER'S NAME Last //R 4 i /,g� / FirstPZA/l/Ziy Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address /
City State Zip Telephone)
ENGINEER'S NAME Last First F Lic. No.�
Engineer's Address Engineer's E-mail Address
City State I Zip F_ Telephoner
CONTRACTOR'S NAME/COMPANY 1, Lic. No. �— Class
Contractors Address Contractors E-mail Address
City State F Zip F Telephone)
SETBACKS REAR SETBACKS FRONT PERMIT NO. X3-102 ( ^ 4LI-
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $