HomeMy WebLinkAboutPV2024-0191 - Permit ApplicationPrint Form IWorksheet for Combo Building & Solar Permit Application 0-0_2�
Comm'I F Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FFFR nl IF AT TINAr no Cl iDRA11ni
r—Building r— Grading
r—Drainage r Elec r—Mech r Plum Cu Yd cut Cu Yd Fill F_
Project Address (Not mailing address) F_ r Fire r Liq r— Landslide FN/A Floor Suite No
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Description of Work
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Use �onst Type
# Storieyj ! Units (if Res)_
Valuation $ 1 L
Material/Labor i �I Ooc)
New/Add SF_
Remodel SF_ Garage/New/Add F!
OWNER'S NAME
Last VY)' � First T ev)
Owners Address
Owner's E-mail Address
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City
StateI�
ZIP l Telephone 7 /cl —6 t'q
APPLICANT'S NAME
Last o
C 11:Vt3 First JT
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Applicant's Address
Applicant's E-mail Address
City I
State �— Zip F_ Telephoned--
ARCHITECT/DESIGNER'S NAME
Last �Y'NCncA First F_,��,n,��-, LicNo. Cr/�r�gt�.
Architect
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Designer's Address
Architect/Designer's E-mail Address
City F�
State F— Zip F_ Telephone�—
ENGINEER'S NAME
Last First F_ Lic. No.F_
Engineer's Address
Engineer's E-mail Address
City
State �— Zip F— Telephoned --
CONTRACTOR'S NAME/COMPANY
-VI e f . , Lic No
J I' Iyi,, Class
Contractors Address
Contractor's E-mail Address
City
State F— Zip [_ Telephoned--
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SETBACKS REAR
SETBACKS FRONT PERMIT NO. —
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO:
USE ZONE
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+,
DEVELOPMENT NO � 1 00 0 r PLAN CHECK FEES $