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HomeMy WebLinkAboutXR2024-0164 - Permit ApplicationPrint Form_ J Worksheet for Combo Building & Solar Permit Application �Rr a � Corri F✓Resident ial City of Newport Beach - Building Division i NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL..: Fv/Building Grading F-Drainage I- Elec Mech r Plum Cu Yd cuts Cu Yd Fill Project Address (Not mailing address) I— Flood r Fire r Liq j- Landslide FN/A Floor Suite No 11-_5 6 j-,7 0\j V I LLig- W )q e— F_ F_ Description of Work Use s Const Type s # Stories # Units (if Res)[_ Valuation $ c. Material/Labor J %j crUO New/Add SFs Remodel SF qWo Garage/New/Add F— OWNER'S NAME Last First l _,�9K0 Owner's Address Owner's E-mail Address 112.5 60HN Lc LLE city N Ox,PiP- State C f'y- Zi P 9Z/dOU Telephone (cjyci 33E5-- �/oZi 1 APPLICANT'S NAME Last 1� rcr�> ZIbUE7 First I(�UIZ %lT1C�� Applicant's Address 11'72y o-)� Applicant's E-mail Address City State CA Zip c,r, 3( Telephonif 2)t,',�_t,7''34 ARCHITECT/DESIGNER'S NAME Last Firstf --- I Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address City s State F_ Zip �_ Telephone[— ENGINEER'S NAME Last sX;k;si (4 First I- - — Lic No. � tl 7'+h� 1/ G 5� L S Engineer's Address Engineer's E-mail Address 22Q7 P 1tL17 l�\t�h1LL v1r}1 7�Z 1 k\3LiNt�ZrrV:� City I %',-\ t2-- t-16o\l-k t� State C tN Zip t'7�_3 Telephone (z\3) Z`il—Q-(-i'r'� CONTRACTOR'SNAMEICOMPANY �� Lic No. `�%CLi03 Class Contractor's Address Contractors E-mail Address 1�1ZL� m�l�it�e-l/157?1 1�/2(�[t 17t��UI�ICL;?n•�!�-lA-'T1U,.i �v� �cvyl�(L.,WV� City I vjkA) m State CA Zip �(U(c,01 Telephone SETBACKS REAR SETBACKS FRONT PERMIT NO. /� ItG 02�i SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.�.©�, USE ZONE DEVELOPMENT NO PLAN CHECK FEES $