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HomeMy WebLinkAboutXR2024-6699 - Permit ApplicationL- Print Form Worksheet for Combo Building & Solar Permit Application @W� FfiComm'I FL -Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL rt4uilding j-Grading [-Drainage F_Elec rMech F-Plum Cu vd Cut Cu vd FillF_ Address (Nopt) mailing address) r Flood i— Fire r Liq r Landslide FN/A Suite No Project /Floor � Description of Work �7f^/d,>�/-X, UseUConstType 1�—T, Stories Z /y # Units (if Res) " / SC�Z p j /x-- Valuation $ z Material/LLa'bor %' _ New/AddSF� Garage/New/Add - OWNER'S NAME/�//1eA/77'1' i Co fi i7/ cr'S Owner's Address Owner's E-mail Address City State l 7,' Zip �//7 Telephone/ 7;0 - =11 APPLICANT'S NAME Last First L..,IAt V Applicant's Address Applicant's/ E-mail Address 20l ko hi'> /a f o/G'Y A4iY- �?(TLvzol c�Q/¢q�r g�ii��G City J/li ijcm -s i A ? F State A Zip � �G'lA L Telephone // / ` • G'y �S-e7 ARCHITECT/DESIGNER'S NAME Last /2714. First 77A,�� j�� Lic. N -2y-Z�y Archittee`cctlgDesigner's Address Architect/Designer's E-mail Address / IF City State 1-.Z TelephoneF— ENGINEER'S NAME Last First 7— Lic. No.1 Engineers Address Engineer's E-mail Address City State F Zip �— TelephoneF CONTRACTOR'S NAME/COMPANY tli Yl3 t-n�iV%Ct►'fy%4_ NC4.�Il Lic. No. b5 i6 3 � Class Contractor's Address Contractors E-mail Address 22330 Oel (ai� o evor g b2 V1 ►VIce%. c o vv-� City 1 Li( klvl� k! (15 State I C Zip i 2613 Telephone 11l (4o2 8163 fX SETBACKS REAR SETBACKS FRONT PERMIT NO. Z-ZU+-0 6 1 G SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $