HomeMy WebLinkAboutXR2024-6405 - Permit ApplicationPrint Form ___I Worksheet for Combo Building & Solar Permit Application (692
r Comm'I j- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME nF CI IRnnITTG
Building r- Grading
r-Drainage r Elec r Mech j- Plum Cu vd cut Cu vd Fill F
Project Address (Not mailing address) r Flood r Fire r Liq r Landslide f N/A Floor Suite No
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Description of Work
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Use F— Const Type
r---
# StoriesF # Units (if Res)[—
Valuation P
Material/Laabo
New/Add SF�—
�—
Remodel SFGarage/New/Add�—
OWNER'S NAME
Last First
Owner's Address
Owner's E-mail Address ` 2.4 Ati
City �—
State F_ Zip F— Telephoner —
APPLICANT'S NAME
Last nn
�3- First
Applicant's Address
Applicant's E-mail Address
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State Telephone ], y: qo /—z I,"
ARCHITECT/DESIGNER'S NAME Last �—First F_
Lic. No. �—
Architect/Designer's Address
Architect/Designer's E-mail Address
City I
State I Zip F TelephoneF_
ENGINEER'S NAME
Last First F_ Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City
State �— Zip F_ Telephone
CONTRACTOR'S NAME/COMPANY 1// — Lic. No. �p Class ?
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Contractor's Address
Contractor's E-mail Address
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City Cy�— w L
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State Zip j LSt:, Telephone 71 Ll
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK N
USE ZONE
DEVELOPMENT NO PLAN CHECK FEE