HomeMy WebLinkAboutXR2024-6228 - Permit ApplicationPrint_Form Worksheet for Combo Building & Solar Permit Application a
`City of Newport Beach - Building Division 3ij�Eomm I residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Foa�
Building #4&ading
F-Drainage rElec j-Mech F-Plum Cu Yd Cut Cu Yd Fill�
Project Address (Not mailing address) F_ Flood r Fire r Uq r Landslide F_N/A Floor Suite No
Description of Work J&,4A-111,4 7�X/477?J).
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# Stories�LIUnits (if Res)
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Valuation $"�
Material/Labor�j
New/Add SF�—
8eaaec#eFSF 7 C-� Garage/New/Add
OWNER'S NAME/,,4,
Owner's Address
Owner's E-mail Address
City �'r�/
State Zip f � Telephone / "TZc
APPLICANT'S NAME
Last 7%Z-Gi First
Applicant's Address
Applicant's E-mail Address
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City '�G/�G'f SL�a7 State C,r( Zip / 1✓F"� Telephone ��- ��>
ARCHITECT/DESIGNER'S NAME Last %?^/Vr,z j First � Ji�� Lic No. -2 Z2c�_
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State ..p Telephoned
ENGINEER'S NAME
Last First 7— Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City I
State I Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY Lic. No. F__ ClassF
Contractor's Address
Contractor's E-mail Address
City
State F_ Zip F Telephoned
SETBACKS REAR
SETBACKS FRONT PERMIT NO. —yL7 4 2-L
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK N .
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $