HomeMy WebLinkAboutXR2024-6404 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
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Comm'1 V Residential City of Newport Beach - Building Division q
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
j Building r Grading rDrainage r Elec r Mech
r Plum Cu Yd Cut Cu Yd Fill F
Project Address (Not mailing address) f Flood
r Fire r Liq r Landslide N/A Floor Suite No
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Description of Work
Use Const Type
# StoriesF # Units (if Res)r—
Imo'
Valuation $
Material/Labor F
New/Add SFr— Remodel SFF Garage/New/Add F—
OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
City � State F_
ZipF TelephoneF_
APPLICANT'S NAME Last V'
First Ct ,
Applicant's Address
Applicant's E-mail Address
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City o2 ,�_0 State C.T
Zip 9 z Y& Telephone )/ tl _ S p� . Z Z7�
ARCHITECT/DESIGNER'S NAME Last
First Lic. No. r--
Architect/Designer's Address
Architect/Designer's E-mail Address
City State
Zip F_ Telephoned
ENGINEER'S NAME Last
First F Lic. No.r--
Engineer's Address
Engineer's E-mail Address
City I State F_
Zip F_ TelephoneF_
CONTRACTOR'S NAME/COMPANY , Lic. No. /T � ZZ Class F13
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Contractor's Address
Contractor's E-mail Address
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City � State C4
Zip � (, Telephone 7,yyou/..? Z_/
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK N
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $