HomeMy WebLinkAboutU2024-5223 - Permit ApplicationPrint Form 1 Worksheet for Combo Building & Solar Permit Application o4 EW�ae
- Comm'l (- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME nF RI IRMITTGI _
Building r- Grading r-Drainage r-Elec [- Mech r Plum CuvdCut F_ CuYdFill F_
Project Address (Not mailing address) r— Flood r Fire r- Liq r" Landslide i—N/A Floor Suite No
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Description of Work
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# StoriesF— # Units (if Res)r—
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Valuation $
Material/Labor SY Cam' w
New/Add SF LP () h( Remodel SF �— Garage/New/Add F—
OWNER'S NAME Last F) . re.nQ
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First rst
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Owner's Address
Owner's E-mail Address
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APPLICANT'S NAME Last L i Ll
First l>0L)4c
Applicant's Address
Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last �—
First A' ?- I Lic. No. �f
Architect/Designer's Address
Architect/Designer's E-mail Address
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ENGINEER'S NAME ��II l A Last
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First F— Lic. No.7—
Engineer's Address
Engineer's E-mail Address
City State I
Zip F— Telephoner--
CONTRACTOR'S NAME/COMPANY p��^C-� \L��TjD Lic. No. 6;(6236 ClassC-LDS
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Contractor's Address
Contractors E-mail Address
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SETBACKS REAR SETBACKS FRONT
PERMIT NO. 12024 -S ZZ3
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $