HomeMy WebLinkAboutXR2024-6423 - Permit ApplicationPrint Form Worksheet for Combo Building& Solar Permit Application @39-1,2
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r�mm'I F_t4esidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
FC,KuiIding r Grading (—Drainage r Elec r Mech r Plum cuYdCut CuvdFill
Project Address (Not mailing address) F_ Flood I— Fire r Liq j— Landslide F_N/A Floor Suite No
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Description of Work
Use Const Type �A
# StariesFT #Units (if Res) J�`
Valuation /
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New/Add SF R Gara a/New/Add
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Material/Labor /
OWNER'SNAME %?Y�7ayvy Prst
Owner's Address Owner's E-mail Address
J� ?/'/��'��y'�G�%��a���./Y'U/NL''C'0lllt�itiz�'L<T¢•r
City State Zip /7u, i 7 Telephone '�" 72-1' -
APPLICANT'S NAME Last / /`ZG�%,X First A (/
Applicant's Address Applicant's E-mail Address
City % State l Zip Telephone
i �i'%� i /
ARCHITECT/DESIGNER'S NAME Last—/VG',r First —
�,2 ! fl.iG'��l Lic. N
Architect/Designer's Address Architect/Designer's E-mail Address
City State Telephone
ENGINEER'S NAME Last First I Lic. No.F
Engineer's Address Engineer's E-mail Address
City State F Zip F— Telephone
CONTRACTOR'S NAME/COMPANY Lic. No. F Class
Contractor's Address Contractor's E-mail Address
City State I Zip F Telephone
SETBACKS FRONT PERMIT NO.)(RZO?.gI 64 23
SETBACKS REAR
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $