HomeMy WebLinkAboutXR2024-6947 - Permit ApplicationPrint Form Worksheet for Combo Buildin & Solar Permit A licationVe�Vfomm'I ri R@sidentialCity of Newport Beach - Building DivisionNOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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APPLICANT'S NAME Last -71-;'6111 X First I J/q
Applicant's Address Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last �il JG' % �/ j First Alxt i l
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ArchitecUDesigner's Address Architect/Designer's E-mail Address
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City Stat Zip Telephone
ENGINEER'S NAME Last First �— Lic. No.F—
Engineer's Address Engineer's E-mail Address
City � State F__ Zip F TelephoneF—
CONTRACTOR'S NAME/COMPANY Lic. No. F_ ClassF_
Contractor's Address Contractor's E-mail Address
City �— State r— Zip [— TelephoneF_—
SETBACKS REAR SETBACKS FRONT PERMIT NO. J.&V�jd,-41
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $