HomeMy WebLinkAboutXR2024-6440 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application aw
r Comm'I j��esidential City of Newport Beach - Building DivisionNOTE: PLAN CHECK FEES DUE AT TIME OFSHRMiTTAi
Pt`uilding r Grading rDrainage r Elec r Mech
r Plum cuYdCut l cuYdFill F_
Project Address (Not mailing address) r Flood r— Fire r Liq r Landslide F N/A Floor Suite No
-y Li i�j L E:fit'-'F�-�-
Description of Work
Use F—ConstType
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# Stories #Units (if Res)
Valuation $
Material/Labor
New/AddSFr_— Remodel SFF— Garage/New/AddF—
OWNER'S NAME Last `• �'
First 7 �}
Owner's Address
Owner's E-mail Address
_
City — State r—
Zip F--- Telephone � _ j)7 _7 ;
APPLICANT'S NAME Last k') L
First
Applicant's Address
Applicant's E-mail Address
City { 15L tt �U State-
Zip 76, yJC Telephone ,�07'7�IJ Tj7� Cu
ARCHITECT/DESIGNER'S NAME
Last j/ AC FirstFP— A-AJ Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
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aL) i`
City J77' v 7A vk(. State R
Zip '1756 Telephone qC)
ENGINEER'S NAME Last
First �— Lic. No.F—
Engineer's Address �\A iermail Address
City State �—
Zip F_ Telephoner —
CONTRACTOR'S NAME/COMPANY t �L l A i� `
ti
Lic No.Fit) 3` 761 Class
Contractor's Address
Contractor's E-mail Address
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t�'IC�S(✓� Ct�'1U�/!-Cl�x.15C� E?J%NAIL.
City j : State FT ---
Zip 7 ' Telephone k 1
SETBACKS REAR SETBACKS FRONT
PERMIT NO. XIZ% 024 - (nLtLAO
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $