HomeMy WebLinkAboutXR2024-6041 - Permit Application1.
PrintForn, A Worksheet for Combo Building & Solar Permit cation u�EW'°°R.=
r�6mm'I r" sidential City of Newport Beach - Building Division
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NOTE: PLAN CHECK FFFnl jrIF AT T�KAC no ci loran =A1
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Project Address (Not mailing address) r Flood r Fire r Liq r Landslide rN/A Floor Suite No
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Description of Work �� /4 rS�9�-7� L1
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Use t / r/ ConstType
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# Stories #Units (if Res) /
Valuation a
Material/Labor rZ7 � W
New/Add SF �- — F Garage/New/Add �—
OWNER'S NAME
Owner's Address
Owner's E-mail Address
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City i %z v: ///� State
- Zip _�%��i f7 TelephoneF9W•— 72W _ Ze
APPLICANT'S NAME Last 7R j 1,f X First
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Applicant's Address
Applicant's E-mail Address
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City %��d/ i C,A Se N r State J G
a Zip / 2 Telephone 9¢—
ARCHITECT/DESIGNER'S NAME Last �j %�il� P.' / First (� ntibY Lic.N
Architect/Designer's Address Architect/Designees E-mail Address
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City State F Zip 1,
NAME Last First— �—
Lic. No.
Engineer's Address Engineer's E-mail Address
City State I Zip F_ Telephoned --
CONTRACTOR'S NAME/COMPANY �C2 Lic. No. C; I / S Class
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Contractors Address Contractor's E-mail Address
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City State F_ Zip F_ Telephones
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $