HomeMy WebLinkAboutXR2024-6672 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
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j-111LOmm'I FT�ssidential City of Newport Beach -Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) Fj Flood r Fire j— Liq r Landslide F_N/A Floor Suite No
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# Stories] # Units (if Res)
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Valuation
Material/Labor
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New/Add SFF NSF //Z Garage/New/Add F—
OWNER'S NAME/(n C best ��`"/� - (rely ,AAI �Ftrst �- / C
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Owner's Address Owner's E-mail Address
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City % i�N State F7A Zip TelephoneF�F-pz- 72eT -5�z,,7
APPLICANT'S NAME Last 7��V Q k First I A IV
Applicant's Address Applicant's E-mail Address
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City 1h!'iA /C� L%dr(/� State Zip /Cl/� Telephone
ARCHITECT/DESIGNER'S NAME Last ZAi/i1-/d-/ First A,, D'
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Architect/Designer's Address ArchitectlDesigner's E-mail Address
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City �— State F_ one
ENGINEER'S NAME Last First F_ Lic. No.F—
Engineer's Address Engineer's E-mail Address
City State �— Zip F_ Telephone
CONTRACTOR'S NAME/COMPANY Lic. No. �— Class
Contractor's Address Contractor's E-mail Address
City I State �— Zip �— TelephoneF—
SETBACKS REAR SETBACKS FRONT PERMIT NO. i v}'(y
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $