HomeMy WebLinkAboutXR2024-0470 - Permit Application{ City of Newport Beachy- Building Division pp
Pint Form Worksheet for Combo Building & Solar Permit Application E °
j— Comm'I F—Residential�
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F— Building r Grading
rDrainage r Elec r Mech r Plum CuYdCut CuYdFill F
Project Address (Not mailing address) r Flood
r Fire r— Liq r— Landslide I —N/A Floor Suite No
Description of Wor
Use [_ Const Type F-
S
fib G i-C"C—c; r
#Stories #Units (if Res)
26 kw (gvta�
o�w.d,��
Valuation$
New/Add SF�—
Remodel SF�—
Garage/New/Add
Material/Labor l6�Dod
OWNER'S NAME
Last
First
Owner's Address
Owner's E-mail Address
City
State �—
Zip F Telephoned
APPLICANT'S NAME
Last F
First
Applicant's Address
Applicant's E-mail Address
City
State I
—
Zip F TelephoneF
ARCHITECT/DESIGNER'S NAME Last
First 7 �—
Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City �
State F
Zip F TelephoneF—
ENGINEER'S NAME
Last
FirstF Lic. No.1
Engineer's Address
Engineer's E-mail Address
City
State �—
Zip Telephoned
CONTRACTOR'S NAME/COMPANY A �� Lic. No. 6 )TI / Class C ,�
K
WOr\
Contractor's Address
Contractor's E-mail Address
(�02� pto�lrGL
/
/7/;
City �� /,
State
Zip �a r;� F S- TelephoneF? (c( 0 _g jq� ar is
SETBACKS REAR
SETBACKS FRONT
PERMIT NO. )(&O& �Oq jo
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO. �C202V-039%
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $