HomeMy WebLinkAboutXR2024-6201 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application�Rr
Comm'] Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F_ Building j—Grading j—Drainage rElec F_Mech F—PlumCuvdCut F CuvdFill F
Project Address (Not mailing address) r Flood r Fire r Liq r- Landslide rN/A Floor Suite No
�—
Description of Work
Use F ConstType F
# StoriesF_ # Units (if Res)F_
)'
ZdJ C&C gG rO �i� [ �� �"
Valuation $
New/AddSF1 Remodel SFF Garage/New/Add �
Material/Labor
OWNER'S NAME Last ��� First P.0/,
(
Owner's Address Owners E-mail Address
I
3 6L M v 0 0 + t
/tOc7,'C!
City % Y Caw o {l-loGr ` State Zip � Telephone 5Z`� ?�11 T -6 �l
APPLICANT'S NAME Last C) First () a C)( (0 7 S
Applicant's Address Applicant's E-mail Address
2I� (��✓//c , �UOcQ/ rrlczti,i, e0
'
City f�i ZiAI��L � State rt Zip Z W (b 3 Telephone C
`1 V'? ; _ 833 0
ARCHITECT/DESIGNER'S NAME Last First �— Lic. No. I
Architect/Designer's Address Architect/Designer's E-mail Address
City I State �- Zip I Telephoned
ENGINEER'S NAME Last First �— Lic. No.1
Engineer's Address Engineer's E-mail Address
City State �— Zip �— Telephoned
CONTRACTOR'S NAME/COMPANY Lic. No. F Class F
Contractors Address Contractor's E-mail Address
City State F_Zip F Telephoned
SETBACKS REAR SETBACKS FRONT PERMIT NO. )Q
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $