HomeMy WebLinkAboutXR2024-6406 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application °SEW °ara
r Comm'I Residential City of Newport Beach - Building Division °
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding rGrading F-Drainage (-Elec rMech
F- Plum CuydCut F CuYdFill F
Project Address (Not mailing
address) F_ Flood
r Fire r Liq r Landslide rN/A Floor Suite No
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Description of Work
llJTE(?Aor- OF
007- /N GLUT>I`A*,
Use F—ConstType
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I �'
# Stories #Units (if Res)
Valuation $
Material/Labor 501c_
New/Add SFF__ Remodel SFF— Garage/New/Add —
OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
City
State �—
Zip F— Telephoned
APPLICANT'S NAME Last
n/1
r r I �-rv� t�
First
Applicant's Address
Applicant's E-mail Address
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rn ti o � 2� v i S n9- <G .�; I-,,c,�, �n c •�_ Cc� c�a-�/ 9-t � �
City b L
State I `-'r
Zip C6 � Telephone 7 /l(- cJ 0 L z z 1' 7
ARCHITECT/DESIGNER'S NAME
Last
First F_ Lic. No. F—
Architect/Designees Address
Architect/Designer's E-mail Address
City
State �—
Zip F Telephoned
ENGINEER'S NAME Last
First F__ Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City
State F__
Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY t�noEtia�r4S sx�c Lic No. (oyrzz Class
Contractor's Address
Contractor's E-mail Address
11
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City
State I C—A
zip Telephone
SETBACKS REAR
SETBACKS FRONT
PERMIT N
SETBACKS LEFT
SETBACKS RIGHT
PLAN CH4
USE ZONE
DEVELOPMENT NO
PLAN CH C FEES $