HomeMy WebLinkAboutXR2024-6492 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division t
j--Comm'I �'�esidential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL V
FF,uilding rGrading F-Drainage rElec rMech j-Plum Cu ed cuts Cu Yd Fill
Project Address (Not mailing address) i— Flood r Fire j- Liq r Landslide F_N/A Floor Suite No
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Description of Work%2Oti 23'r e // %
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# StoriesFT # Units (if Res)�t�
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New/Add SF SF i Garage/New/Add a/New/Add
Valuation $
Material/Labor
OWNER'S NAME -L `mil /� �C!L//�/i�t/y --4 s �p/r%2TX�l �Lf Jtr�v4G' 5
Owner's Address Owner's E-mail Address
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City �� State r N Zip 74'/ -7 Telephone /TT 7/2 /
APPLICANT'S NAME Last %/' !U//X First may.
Applicant's Address Applicant's E-mail Address
City /SSG; I� State Zip C%2' j , Telephone :��/—"2�lGJ cxa��
ARCHITECT/DESIGNER'S NAME Last �t ipFirst E'l-1,1,51 Lic.N •-2¢Z2?
Architect/Designer's Address Architect/Designer's E-mail Address /
City State Telephones
ENGINEER'S NAME Last First 7_ Lic. No.s—
Engineer's Address Engineer's E-mail Address
City I State F_— Zip F_— TelephoneF_—
CONTRACTOR'S NAME/COMPANY Lic No. TTFq3 Class
Contractor's Address Contractor's E-mail Address
City State F_ Zip F_ TelephoneF_
SETBACKS REAR SETBACKS FRONT PERMIT NO. 2i V 11
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $