HomeMy WebLinkAboutXR2024-6455 - Permit ApplicationPrint Form _l Worksheet for Combo Building & Solar Permit Application
FiComm I residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
U,Btiilding r- Grading rDrainage r Elec r Mech r Plum Cu vd Cut Cu vd Fill F
Project Address (Not mailing address) F_ Flood r• Fire r/Liq r- Landslide FN/A Floor Suite No
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Description of Work �/l% rL ; �[t-el/L' r; L7/ �" /t xj
Use#71,'ConstType t T
# Stories FJUnits (if Res
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New/Add SFF l F Garage/New/Add F
Valuation $// (�-G'
Material/Labor
OWNER'S NAME rq j�V`N �Z'J/�i fj/(i Frs! , 11 r
Owner's Address Owner's E-mail Address
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City V ,� jl/ State (7A Zip 2 / � Telephone C�,, - 1
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APPLICANT'S NAME Last T/2 �,- /d \( First /� y
Applicant's AddressApplicant's E-mail Address
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City �L /�C/� �S (��' State CA Zip (7 Telephone
ARCHITECT/DESIGNER'S NAME Last /2-7 14Z// Ff / First i4/'./ �� • •�(
- �)/ Lic. No. / _ 0tl
Architect/Designer's Address Architect/Designer's E-mail Address
rf A s -A/2�
City State
ENGINEER'S NAME Last First F— Lic No.F—
Engineer's Address Engineer's E-mail Address
City State F_ Zip F_— Telephoned
CONTRACTOR'S NAME/COMPANY Lic. No. I ClassF
Contractor's Address Contractor's E-mail Address
City I State F— Zip F Telephoned
SETBACKS REAR SETBACKS FRONT PERMIT NOt�I$
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $