HomeMy WebLinkAboutXR2024-6291 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
It -Comm'] V<esidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) F- Flood r Fire r Liq j- Landslide rN/A Suite No
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Description of Work //7 e2-u
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# Stories # Units (if Res)T
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Valuation $ T
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OWNER'S NAME(IC,%f G
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Owners Address Owner's E-mail Address
City 715//%/vf- State FA Zip /7 TWepti6ne-�/—0
APPLICANT'S NAME Last �%� (//� First I JA `/
Applicant's Address Applicant's E-mail Address
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City �jfl & 1z)67,4/— �i�
State Telephone
ARCHITECT/DESIGNER'S NAME Last iZ /AA11,e First I AA', / Lic. No. _2" 7 2��
Architect/Designer's Address Architect/Designer's E-mail Address
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City State �— Telephoned
ENGINEER'S NAME Last First �— Lic. No.F_
Engineer's Address Engineer's E-mail Address
City State F Zip I Telephone
CONTRACTOR'S NAME/COMPANY Lic. No. F— Class
Contractor's Address Contractor's E-mail Address c)iL2
City State �- Zip �— Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO.2y2�{- 62g
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $