HomeMy WebLinkAboutXC2024-0296 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division
r Comm'I r Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Flood i— Fire i— Liq r Landslide
Project Address (Not mailing address) r
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Description of Work
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New/Add SFr —
OWNER'S NAME
Owner's Address
City �—
Remodel SF
Last ) (l a wore
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Cu Yd Fill
i—N/A Floor Suite No
Use s ConstType s
_ # Storie/s/�](/[� # Units (if Res)s
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Garage/New/Add �— MateriaULaborl
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Owner's E-mail Address
State F— Zip F�
,PPLICANT'SNAME Last W_V_0
1pplicant's Address
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State I CA
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Applicant's E-mail Address
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Zip Of 70 Telephone b Z (v 3 3 t1 S Cfl 0 0
ARCHITECT/DESIGNER'S NAME Last Lic. No.
First I
r it c e is E-mail Address
Architect/Designer's Address
State F_ Zip V� TelephoneF�
City
ENGINEER'S NAME Last
First— Lic. No
Engineers E-mail Address
Engineer's Address
State F_— Zip Telephones --
City
Lic. No. 1-7 q&&S-(. c.lassi � L3
CONTRACTOR'S NAME/COMPANY byjCyt kGINYVV l �k StSw
Contractor's E-mail Address
Contractor's Address I I Pd
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State F' Zip � � -7 Z Telephone 6 Z � 3 k Sc� ena
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SETBACKS FRONT PERMIT NO. 'f 1-0L4 — UZA b
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SETBACKS RIGHT PLAN CHECK NO.
DEVELOPMENT NO (JZU� (I PLAN CHECK FEES $