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HomeMy WebLinkAboutXR2024-7079 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application o�`Qo°arm omm'I ft,4esidentia1 City of Newport Beach -Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL j'Wuilding rGrading F-Drainage j—Elec rMech rPlum Cu yd CutF_ Cu Yd Fill Project Address (Not mailing address) r Flood r Fire r Liq r Landslide I —N/A Floor Suite No Description of Work i1f,'4" 1—?�- �A{ J PYl� �2 <.; �3z f7 rpY( Use L- �ConstType-/3 # StoriesF # Units (if Res) ?2 I' y �yV J`&#j %ZS (I aV A% �li"r U.c�, ' ✓C. /I /`�G� /%tx . Valuation $ �.i�) r' Material/Labor / E`%T New/Add SF �/� R rondel SF / �7f Garage/New/Add r OWNER'S NAME('CA C-,—L.et- 1112 U i /`L'l•� �('l �•y"-' '/i 7v C " First Owner's Address Owner's E-mail Address City /LL r hirt State 7/q Zip I"� /'7 Telephone ";" - 7Z�,4 APPLICANT'S NAME Last ��� (j A > First �� Applicant's Address Applicant's E-mail Address �/�v�•;r ! vL z, 20/f�"" �// AS City D7IZ),A 1SZ-AM•� State Zip /ZErc�L Telephone f- `zT I� ARCHITECT/DESIGNER'S NAME �� � ` Last ¢ j First �> avLi Lic. N Architect/Designer's Address Architect/Designer's E-mail Address ^ A /6-6e) v r City State Zip Telephone F_ ENGINEER'S NAME Last First F Lic. No.� Engineer's Address Engineer's E-mail Address City State I— Zip � Telephoned CONTRACTOR'S NAME/COMPANY Lic No. I Class I Contractor's Address Contractor's E-mail Address City � State Zip [_ Telephoned — SETBACKS REAR SETBACKS FRONT PERMIT NO. CL I C) SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $