HomeMy WebLinkAboutXR2024-6585 - Permit ApplicationPrint_Form Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division
r Comm'I r Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding r Grading rDrainage r Elec
ect Address I
rMech Plum CuYdCut I CuYdFill
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Firer Liq r Landslide
rN/A Floor,
Suite No
Description of Work
1'S/G// 1725'l-4 ^#
Use Const Type
# StoriesF— # Units (if Res)F—
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Valuation a I'7 /;i�
New/Add SFF-- Remodel SF Garage/New/Add �— Material/Labor f l ( O
OWNER'S NAME Last First
Owner's Address Owner's E-mail Address
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City (u%,T')r't i_CC '% State I Lam' Zip l Z�'6C Telephone �k/F ��j� (—
APPLICANT'S NAME Last I First
Applicant's Address Applicant's E-mail Address
City
State �— Zip F_ TelephoneF�
ARCHITECT/DESIGNER'S NAME Last �Gt/� d First J�,yt� Lic. No. �—
Architect/Designer's Address ArchitecUDesigner/s E"-mail Address
City State F— Zip [— Telephone�—
ENGINEER'S NAME Last
Engineer's Address
First
Engineer's E-mail Address
Lic No.F—
City
State �— ZIP �— TelephoneF�
Lic. No. lQ/S/3C/ Class
CONTRACTOR'S NAME/COMPANYf2
Contractors Address Contractor's E-mail Address
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City F t
State C .� Zip
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SETBACKS REAR SETBACKS FRONT PERMIT NO. xI1 of __�a 95
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $