Loading...
HomeMy WebLinkAboutXR2024-6927 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application °�`�`°Re rmm'I Cor Residential City of Newport Beach - Building Division 9 NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL ��,�oaa.� r-Building F-Grading F-Drainage F-Elec rMech F-Plum CuvdCut CuvdFill F Project Address (Not mailing address) f Flood [- Fire j- Liq j- Landslide F N/A Floor Suite No 'lG - ",� i'�., hi✓)L... I Description of Work Use F—ConstType F_ # Stories #Units (if Res) j ©s O©Q Fl _ � New/Add SF Remodel SF (_. �� =; % ,_ Garage/New/Add I Valuation $ Material/Labor , OWNER'S NAME Last First Owner's Address Owner's E-mail Address City A%_ < �. 'f- l� Y�") State %f� .- -��.<C t_ t Zip y Telephone l ? �IZ.I(:.��5_..1� APPLICANT'S NAME Last. �j First Applicant's Address Applicant's E-mail Address 1 i State Zic�(TelephoneCity Tr ARCHITECT/DESIGNER'S NAME Last First Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address City State Zip F Telephoned ENGINEER'S NAME Last First Lic. No.r Engineer's Address Engineer's E-mail Address City State Zip F Telephoned CONTRACTOR'S NAME/COMPANY ' �'A Ij� I Lic. No. j ii CIassF ` " , Contractor's Address Contractor's E-mail Address ' City" : �. /..Z \ State �:' Zip C� •� L� Telephone t.�l� SETBACKS REAR SETBACKS FRONT PERMIT NO. x,?Z OZ S q Z SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $