HomeMy WebLinkAboutXR2024-7093 - Permit ApplicationPrint Form ) Worksheet for Combo Building & Solar Permit Application @P!o
iComm'I Residential City of Newport Beach - Building Division \_NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL „.•�
CBuilding rGrading rDrainage F_Elec rMech
rPlum CuvdCut [-- CuYdFill F_
Address (Not mailing address) r Flood
I— Fire r Liq r Landslide rN/A Floor Suite No
/Project
Description ofWork GL'i�rz /��xao�•r ��->�/'i'TJ�x1J
Use ConstType( —4
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# StoriesFa1' # Units (if Res)�j�'
�`
19'3YV C'-1AZS Airv,?
Valuation $ _7P c>c
Material/Labor 7, yt
a�
New/Add SFRe I SF �` Garage/New/Add �—
OWNER'S NAME/C/,,Ileast //2 v �ti'g (1'Nr �nrc First �/ iz'- — o o 'l'
Owner's Address
Owner's E-mail Address
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_
wle y
city I � / Z !' /(' State s�
Y
Zip 7' , 77 Telephone % 7'� f J ��, aG_ a,� Zf
APPLICANT'S NAME Last % C/ Ar >
First J/ /t 7
Applicant's Address
Applicant's E-mail Address
City ��/y.J L q �rj�t�v>� State />
Zip �f'7 /'� Telephone /
ARCHITECT/DESIGNER'S NAME Last �/I ,tl!�'JZ% First ���' �/ Lic N'�9-2o_�
Architect/Designer's Address
Architect/Designer's E-mail Address
Sji•'�t A� V 'L
City State
Zip Telephone
ENGINEER'S NAME Last
First �— Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City State �—
Zip F— Telephonel—
CONTRACTOR'S NAME/COMPANY
Lic. No. F Class
Contractor's Address
Contractor's E-mail Address
City State �
Zip I Telephone
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $