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HomeMy WebLinkAboutXR2024-6415 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application r Comm rx Residential City of Newport Beach - Building Division J NOTE PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Building j— Grading 40Drainage r-r Mech A-, cu vd cut I Cu vd Fill F Project Address (Not mailing address) F_ Flood j- Fire I- Liq i- Landslide FN/A Floor Suite No f 4 lc)i7Debo-GV\ Ln F— F_ Description of Work Use F—Const Type F_ # Stories_ # Units (if Res)_ F,ee I s key, ooA VpnN LccWce akto Co`'e'r 1 • 311�r, yy t�eq�ccCe alas �rn.v�q -� Valuation$ / Fjzoj• New/Add SF RemodelSF�— Garage/New/Add— Material/Labor OWNER'S NAME Last H° C3�.v-, First �� ct.11 Owner's Address Owner's E-mail Address 1 fL.Vt2�_-rn ,� q UPjj�sll�\�I�l� �J� r Cbrv) 1_ City �o�,1?r•K-� `7cj�Qi1'` State �(�} Zip c7Z660 Telephone -_?1j -z[[6p 2elb APPLICANT'S NAME Last r�17�T1 Sj First I j4{_4vje,fy( C7 Applicant's Address Applicant's E-mail Address 1(o 2j S • �_tA" I n 4v-e e , co w City I (,�qDqa State I � " Zip cfZ�82 Telephone Z`q-!;5f-w(o ARCHITECT/DESIGNER'S NAME Last First F— Lic. No. F Architect/Designer's Address Architect/Designer's E-mail Address City I State r— Zip [— TelephoneF— ENGINEER'S NAME LastF First �— �-y Lic. No.r Engineer's Address Engineer's E-mail Address City State �— Zip �-- TelephoneF— CONTRACTOR'S NAME/COMPANY � o cb e %-1 q e ( J 6 G Q N Lic No. �f{Z1j IS Clas �j � j � Contractor's Address Contractor's E-mail Address 20470 —alLavev'ct g r c c#_ City \!� f(�u q State C(;a' Zip -1 Zge 7 Telephone 7)q- qZ© -yq SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $