Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAboutXR2024-6653 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application (S',
- —� 9 ppr Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building rGrading
F-Drainage rElec rMech rPlum Cu rd cut Cu Yd Fill
Project Address (Not mailing address) r Flood r Fire f Liq r Landslide FN/A Floor Suite No
q n_2 � (J
ILISti��t\nt\'t� 7
Description of Work
Use �zConst Type 'v-g
# StoriesF # Units (if Res)F
Valuation $
Material/Labor
New/Add SFF_—
Remodel SF 7`al- Garage/New/Add �—
OWNER'S NAME
Last First
Owner's Address
Owner's E-mail Address
City
State I Zip F TelephoneF_
APPLICANT'S NAME
Last �— First
Applicant's Address
Applicant's E-mail Address
City
State F_ Zip F_ Telephoned
ARCHITECT/DESIGNER'S NAME Last First r— Lic. No. �—
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State I Zip F— TelephoneF_
ENGINEER'S NAME
Last First Lic. NoF
Engineer's Address
Engineer's E-mail Address
City
State F_— Zip F Telephone
CONTRACTOR'S NAME/COMPANY Lic. No. F_— Class
Contractor's Address
Contractor's E-mail Address
City
State �— Zip F_ Telephoned
SETBACKS REAR
SETBACKS FRONT PERMIT NO. XI 0 2-L� 465 3
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $