HomeMy WebLinkAboutXC2024-0363 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit App ' tion
Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTA
KBuilding r Grading F-Drainage 11;Elec '1�Mech F-Plum cuvdcut dFillF
Project Address (Not mailing address) r Flood r Fire r Liq r' Landslide I —N/A Floor_�
of Work
0
Suite No
Use I �' ConstType is -T
# StoriesF # Units (if Res)F—
W-D
Valuation $
Remodel SF 32 Garage/New/Add �— Material/Labor
New/Add SF�
OWNER'S NAME Last l First I(XN of N6'wou--T
Owner's Address Owner's E-mail Address
City State Zip F— Telephoned
APPLICANT'S NAME Last First First uzz:��,
Applicant's Address Applicant's E-mail Address
City (�S nt�PC State � Zip �a Telephone
ARCHITECT/DESIGNER'S NAME
Last P� �-�.� First '�°�y >`i;[A, Lic. NoT—
Architect/Designees Address ArchitectlDesigner's E-mail Address
�-,vbu N-AsIT)c, s7 _sue- 2sbc�) ( (zr�tN�C�s z,,�c . Cwr
City �� n� R State Zip q X% Telephone (� - 4 , ( 41
ENGINEER'S NAME Last First �— Lic. NoF
Engineer's Address Engineer's E-mail Address
City � State F_ Zip F_— TelephoneF—
CONTRACTOR'S NAME/COMPANY Lic. No. ' S T ClassF_
Contractor's Address W Contwrac6ttor's E-mail Address
City �( State �- Zip �l ��f Telephone - y - dv�� U
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. j? q `♦- Z c/
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $