HomeMy WebLinkAboutXC2024-0097 - Permit Application_Print Form _j Worksheet for Combo Building & Solar Permit Application 0,` Pq,'o
Comm'l r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
''Building r Grading FDrainage rElec rMech
r Plum Cu vd Cut Cu rd Fill
Project Address (Not mailing address) r- Flood
r Fire r Liq r Landslide r_N/A Floor Suite No
G'hWcl A-1k F (
Description of Work
Use F Const Type
# StoriesF # Units (if Res)F
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Valuation $
SF� Remodel SFF_Garage/New/Add
��n0New/Add
F-11
Material/Labor/0
OWNER'S NAME Last �1�.�, F�)
First (Y.,'C)
Owner's Address
Owner's E-mail Address
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City L _rl.11 q 17C'.l mo i- State C
p � 1 Tele hone
zi _aTl) S p F
APPLICANT'S NAME Last Fj n i4First I to, Lk�_
Applicant's Address
ApplicantsE-mail Address
City�r;a}-)�'y� State r�
zip �� L'(i Telephone 7 if
ARCHITECT/DESIGNER'S NAME Last
First F—
Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City State
Zip Telephoned
ENGINEER'S NAME Last
First 7— Lic. No.
Engineer's Address
Engineer's E-mail Address
City State 7—
zip F— Telephoned
CONTRACTOR'S NAME/COMPANY >CJI 1 n C Lic No. F 5G Class C i O
l
CL15
Contractor's Address
Contractor's E-mail Address e
�1 F,.
n-Fni2- CJ at crn. cc. coo ,rl
City �r,e,V\L;',m State G4 1
ZipFj1`,-r,-n(, Telephone �I (,i 717_1_009c,
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SETBACKS REAR SETBACKS FRONT
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PERMIT NO. X'L CJ Z�1 — 0017
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. 77
USE ZONE DEVELOPMENT NO V Z.cgvt
— D 0 �J PLAN CHECK FEES $