HomeMy WebLinkAboutXR2024-0928 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application
r" Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rTBuilding F_ Grading rDrainage r Elec
oject Address (Not mailing addre:
scription of Work
f�acL
New/Add SFF—
OWNER'S NAME
Owner's Address
City F—
Remodel SF
Last �OiSe�M-vti
r Mech r- Plum Cu Yd Cut Cu Yd rill
r Flood r Fire r Liq I— Landslide I —N/A Floor
:,l . CA Uz,(.3 F—
State F_
it _ 10r'1tk-e- \ zi
Garage/New/Add F
Suite No
Use F—Const Type F_
# StoriesF_ # Units (if Res)F_
Valuation $
Material/Labor F72-o
First) 70[./I, 0,d (1
Owner's E-mail Address d `
�/�.
Zip F— Telephonel—
APPLICANT'S NAME Lastl f�.s� ��� First
Applicant's Address
Applicant's E-mail
TvLState gJ G �/L
City ck pp/ eephoneoZy _-3
53`_ 9f I SOr`
ARCHITECT/DESIGNER'S NAME Last N44f We$ A �j�sst �— Lic. No. F—
Architect/Designer's Address Architect/Designer's E-mail Address
City
ENGINEER'S NAME Last
State F_
Zip F— Telephone ! 6 _108
First � Lic. NoF_
Engineer's Address Engineer's E-mail Address
City State �— ZIPF Telephone[—
CONTRACTOR'S NAME/COMPANY 0wnqlQ illNe t„ &;V Lic. No. 103322 Class
Contractor's Address Contractor's E-mail Address
City
ISETBACKS REAR
State �— ZIP — TelephoneFag _ • IC 55
SETBACKS FRONT
PERMIT NO. 262
I SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $