HomeMy WebLinkAboutXR2024-6134 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application
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Residential City of Newport Beach - Bwlding D v slon
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building rGrading rDrainage rElec i—Mech rPlum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) r Flood r Fire r Liq r Landslide rN/A Floor Suite No
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Z0z / 6.4&,60 a
Description of Work
Use F—ConstType F-?
# Stories T#Units (if Res)[-2-
Valuation $
New/Add SFF— Remodel SF�— Garage/New/Add �—
Material/Labor
OWNER'S NAME Last
Owner's Address Owner's E-mail Address
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City j,DCCJ11� State CA Zip (�? rf� Telephone - '
APPLICANT'S NAME Last F)�L p y(O First I h�7 c.::
Applicant's Address Applicant's E-mail Address
C) - CSC?x SSA r/I'L Cal; 1 ue;"•-'r 0C-) P
City I L'N 9�1 k'.0O q State C4 Zip F2(,.3 /_? Telephone CZ-2)
ARCHITECT/DESIGNER'S NAME Last First 7-, v _ Lic. No. �—
Architect/Designer's Address Architect/Designer's E-mail Address
City (/( ``7 (rc' C r, .4 State Zip 9�'� 3/ TelephonerIz-- ) i.5 7 ,/ 0 y�
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ENGINEER'S NAME Last (� U First �1612L _ Lic No. j 6,
Engineer's Address Engineer's E-mail Address
City �:7 PQ State Fr-4 Zip (� ��v Telephone CC.0 713 7'5 c '' t C
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CONTRACTOR'S NAME/COMPANY Lic. No. F— ClasSF
Contractor's Address Contractor's E-mail Address
City I State �— Zip TelephoneF—
SETBACKS REAR SETBACKS FRONT PERMIT NO. %CR2024 - l 3y
TBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
. ZONE DEVELOPMENT NO PLAN CHECK FEES $