HomeMy WebLinkAboutXR2024-6342 - Permit ApplicationPrint Form j Worksheet for Combo Building & Solar Permit Application (41
FiComm'I f"esidential City of Newport Beach - Building Division�r
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
V6ilding F_ Grading rDrainage r Elec r Mech i— Plum Cu Yd Cut Cu Yd Fill F
Project Address (Not mailing address) F- Flood r Fire r Liq r Landslide FN/A Floor Suite No
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Description of Work Oi4l^d e 1Z-;�C' 0A_A'%'0 A/
UseFI�71,ConstType IA
# StoriesF�T 4 Units (if Res)
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Valuation $ oe+
Material/Labor C/i'.
New/Add SFF— �j�/� Garage/New/Add F—
OWNER'S NAME %CAG �/��i�%i%j 1 ��/il/7!J (/�. F*st /�/�T`C/G° %✓� C�/�I���U�%i�/ `J
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Owner's Address Owners E-mail Address
City //Z_� N� State I t✓ ,A Zip F /� Telephone ; '� — %Z{j' ZE
APPLICANT'S NAME Last AjL First ( !a !
Applicant's Address Applicant's E-mail Address/
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City?�� f /c�ui(lL.' State Zip l Telephoned —j ' 6`j
ARCH ITECT(DESlGNER'S NAME Last `'�4�j� /G �� First A {/%Jy/' Lic N
Architect/Designer's Address Architect/Designer's E-mail/Address
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City S to �� Zip Telephone
ENGINEER'S NAME Last First �— Lic. No.F
Engineer's Address Engineer's E-mail Address
City I State �— Zip � Telephoned
CONTRACTOR'S NAME/COMPANY Lic. No. F_Class
Contractor's Address Contractor's E-mail Address
City � State �— Zip �— Telephoned
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SETBACKS REAR SETBACKS FRONT PERMIT N . V/ r
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $