HomeMy WebLinkAboutXR2024-6970 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application
7�mm'I riResidential City of Newport Beach - Building Division q
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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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
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Use � Const Type
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# Stories # Units (if Res) u�
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Valuation $ Co_l
Material/Labor / Co
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New/Add SFF .Beodul SF 7L� Garage/New/Add �—
OWNER'S NAME
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Owner's Address Owner's E-mail Address
City%�t1� State C-y t Zip �Z/j �7 Telephone
APPLICANT'S NAME Last p c First J,4 y
Applicant's Address Applicant's E-mail Address
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City F75At-1,2A State q Zip ; � Telephone 77T/ `
ARCHITECT/DESIGNER'S NAME Last First ,: /0 y Lic. N � Z�S
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Architect/Designer's Address Architect/Designer's E-mail Address
City ip TelephoneF_
ENGINEER'S NAME Last First F Lic. No.s—
Engineer's Address Engineer's E-mail Address
City I State F_— Zip F— Telephones
CONTRACTOR'S NAME/COMPANY (; Lic. No. rSL,�='r� Class
Contractor's Address Contractor's E-mail Address
City State F_— Zip F Telephoned
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES