HomeMy WebLinkAboutU2024-5357 - Permit ApplicationL.-Pr'ntForm Worksheet for Combo Building & Solar Permit Application jI-PON
[- Comm'I [- Residential City of Newport Beach - Building Division
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[-Building [-Grading [—Drainage [-Elec [-Mech [-Plum Cu Yd Cutl Cu Yd Fill
Project Address (Not mailing address) [- Flood [- Fire [- Liq [- Landslide [-N/A Floor Suite No
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Description of Work
Use �j Const Type
60` ��lnWtNG 1nr
Al. FSC I�1`1 �tTh Li
# StoriesF # Units (if Res)s
Valuation $
Material/Labor
New/Add SF �— Remodel
SF Garage/New/Add �—
OWNER'S NAME Last
First 5�0� lJ
Owner's Address
Owner's E-mail Address
17 Mule i ,A SN +s r N S F�i�� � tw�u . C_ 0 to
City "J 1(tt' Nam-
State (a Zip 9Z6Z.5 Telephone q`jr 37s •z°iZ7
APPLICANT'S NAME Last
I c0 Q First �z U
Applicant's Address
Applicant's E-mail Address
3Q c o25 Gc,.s Dry
Y-1,0 L0 (✓ ksc)q .OFFS 14 N
City N€�'Pc�.rt t3� L4l
State G�— Zip F Tele hone
ARCHITECT/DESIGNER'S NAME
Last�
J0 1 0 First
F Mee id Lic. No. �—
Architect/Designer's Address
Architect/Designer's E-mail Address
3o GolLSW_0�. bR
City N�,Aj f44-C �3
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State I `,," Zip ,iZ61 Telephone —
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ENGINEER'S NAME Last
—tT, FirstC r Lic. No.
Ivw �p �265 3
Engineer's Address
Engineer's E-mail Address
Jtstlz� 0 7 c Gh��1L,Goh
City t��2.9t�
State �— Zip 1Z�4( Telephone 7 „t� (YI S Z 3SG
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CONTRACTOR'S NAME/COMPANY
�LUazcL 4E /t ,�• r � �N Lic NorDl�t� S Class
/ lS/'CContractor's
Contractor's Address
E-mail Address
J dI'�,Ii �ti�yC ie S C�M'h
City ✓�� /) ... , G!,-�'
I " '�—
State I " ZIP (? la y y Telephoned----
SETBACKS REAR
SETBACKS FRONT PERMIT NO. VJ@Zgw 535 7
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. 04026V
USE ZONE
DEVELOPMENT NO PI AN (.HECK PFCC It