HomeMy WebLinkAboutXR2024-5759 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
f Comml Fjo( Residential City of Newport Beach - Building Division 1
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
V,Building j- Grading j—Drainage XElec sAech
X Plum a,ydCut F_ CuvdFill F_
Project Address (Not mailing address) F_ Flood F_ Fire r Liq r Landslide I —N/A Floor Suite No
48 560�l` 1549N0 OBE7, /1/€W1-b4E77BC1-?C#/ 09L 9.26ac N�; ; f
Description of Work
Use ConstType 1/_�j
REMOI/E A49'GL @ K/TGffE / ST/9LL
Q,20P $C-,'9 1�
# Stories # Units (if Res)
EGoNF/GU E G%� E
UE3
aYc /Acc&yla. /G/i%�f I&MLOl
ADO G, E D 's
New/Add SF ;�;6AI - Remodel SF % t2-&LGarage/New/Add l�)
Valuation $
Material/Labor /�j 4940- 00
OWNER'S NAME Last LLER/ ,AC-W
First I ffE�477Y&R- �y/D-GGc�
Owner's Address
Owner's E-mail Address
hCJN e r L&hejd erhcl%r, corn
city %1/�GtJ/OD,QT 3��� State G�
Zip G?z�6C) Telephone 3/D •3B 3 • 094
APPLICANT'S NAME Last
Applicant's `—� ��
Fli,st
LAp �sI
PP
is Address
City I State
Zip F_ Telephoned
ANGNMBMDESIGNER'S NAME Last �j4oU� First 04V/p Lic.No.r
$xftitimMiDesigner's Address
Architect/Designer's E-mail Address
-7, 55 N• /aGLFiV 57
City r M19&f1V4"..11V0 State C —
Zip 9 ,$ Telephone 3/3.231.3�/J
ENGINEER'S NAME Last MC6E'l /ei4
First ,5 I E'L Lic. No. C -
Engineer's Address
Engineer's E-mail Address
J5333 G!J[ V'cR DQ,SU/7�3¢O
jn fo G m1 s jeo. czm
City J,e (// State GA
Zip 9�lTelephone 6$�, 588. it/OS
1y��P�)
!?�! C Lic No. j?�TjC ClassE
Contractor's Address C_
Contractor's E-mail Address
City C'.�. �,.\ ���.d n 0. .-k-j_r/ ate C /:
Zip �2 (IL L� Telephone �JI ,3 — 2 3 1 — 3) / /�t
SETBACKS REAR SETBACKS FRONT
PERMIT NO. X ►V vv Z ' `!� l
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $
1-1
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