HomeMy WebLinkAboutXR2024-5716 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application 010-
Wr Comm'I .7 Residential City of Newport Beach - Building DivisionNOTE: PLAN CHECK FFFR nl IF nT TINAF n❑ cl 1MftA rA1 x
'rBuilding F_ Grading
rDrainage r Elec r Mech Plum F_ l�
r Cu Yd Cutl Cu Yd Fill
Project Address (Not mailing address) i— Flood r' Fire r Liq r Landslide FN/Aj�Floorr Suite No
Description of Work
Uses ConstType s
# Stories # Units (if Res)s
Valuation $
Material/Labor
New/Add SF�— Remodel SF _�—
Garage/New/Add �—
OWNER'S NAME
Last_ � .
First ^-
Owners Address
Owner's E-mail Address
City ._ ,., �.. , .
State I 17 Zip 77-.,clCJ Telephone f_
APPLICANT'S NAME
Last -, F,
First /�`j i, n/,
Applicant's Address
Applicant's E-mail Address
City !•...: p ..
State I -
Zip = `�+.� to Telephone
ARCHITECT/DESIGNER'S NAME Last t j F
First �— Lic. �—
No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City I
State r
—
Zip F TelephoneF
ENGINEER'S NAME
Last t ^ , t', r c. -
First `s,f ,-_• --- Lic. No. -
Engineer's Address
Engineer's E-mail Address
City
State s1
Zip,-:. Telephone-_ _;,q-'7,.�
CONTRACTOR'S NAME/COMPANY — Lic. No. `'t'r -^. TIT Class %.
Contractor's Address
Contractor's E-mail Address
a__ _ i
City r. .l A'•y :, A
-- State _-7
Zip * . 1 1-) Telephone (', ,
SETBACKS REAR
SETBACKS FRONT
PERMIT NO. ! •-"L W
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $