HomeMy WebLinkAboutXR2024-1073 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Ap
— — — _ City of Newport Beach - Building Division
r Comm'I j— Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITAL
rBuilding r Grading rDrainage F—Elec
Project Address (Not mailing addre!
of Work
r Mech r Plum Cuvd
r Flood r Fire r Liq r Landslide
Cu Yd Fill
rN/A Floor Suite No
User—
ConstType F
# StoriesF_ # Units (if Res)F_
Valuation $
New/Add SF� Remodel SF�—
Garage/New/Add �— Material/Labor
First
OWNER'S NAME Last
Owners Address Owner's E-mail Address
I
State-- Zip �— Telephone
City
First
APPLICANT'S NAME Last
Applicant's E-mail Address
Applicant's Address
State r— Zip F� TelephoneF�
City
First-- Lic. No.--
ARCHITECT/DESIGNER'S NAME Last
Architect/Designer's Address
City
ENGINEER'S NAME Last
Architect/Designer's E-mail Address
State F� Zip F� Telephoner�
First— Lic Nof— I
Engineer's E-mail Address
Engineer's Address
State F_— Zip Telephoned --
City
Lic. No. (G2Y71%% Class �S
CONTRACTOR'SNAME/COMPA// � j1� rye'-tt2 -t '�C�'i i ' ✓ -� �
Contractor's E-mail Address
Contractor's Address /
State
CAZip 2 C TelephoneFT
j 7E
City 2-
c�C-
SETBACKS FRONT PERMITNO.
SETBACKS REAR —�
PLAN CHECK NO. PG!-lb��D
SETBACKS LEFT SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $ �—