HomeMy WebLinkAboutXR2024-6480 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application °
City of Newport Beach - Building Division
rt"Inmm'I /Residential _
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL G.',,..�•
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Project Address (Not mailing address) r Flood r Fire r Liq r Landslide rN/A Floor Suite No
Description of Work �.4y%�i2 ( A .��� ��7�n�v°TD"�/
Use F__VoconstType 77;j
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# Stories��„� Units (if Res)
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Valuation $ Z 00
Material/Labor
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New/AddSFF+— F[ Garage/New/Add—
OWNER'S NAME
Owner's Address Owner's E-mail Address
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City ���///V State FCa Zip _up /7 TelephoneWT-7QD-�
APPLICANT'S NAME Las12 JC First
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Applicants Address Applicant's E-mail Address
City I ?!7,4 /i,Z_S dX /C� ,';)State I Zip I %Z&kZ Telephone
ARCHITECT/DESIGNER'S NAME Last ��{ /'��/ First � X AAD�y Lic. No. -
Architect/Designer's Address Architect/Designer's E-mail Address f
City State Zip Telephonej—
ENGINEER'S NAME Last First I Lic. No.F__
Engineer's Address Engineer's E-mail Address
City State F Zip F TelephoneF—
CONTRACTOR'S NAME/COMPANY Lic. No. F Class
Contractors Address Contractor's E-mail Address
City state F— Zip F TelephoneF
SETBACKS REAR SETBACKS FRONT PERMIT NO. X R'Z0'Lc-1 - 6 ! S-(J
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $