HomeMy WebLinkAboutXR2024-6748 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application of PC4am
r Comm'I � Residential
City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL 1.,.o..��
JKBuilding j—Grading rDrainage rElec rMech rPlum CuvdCut F CuvdFill
Project Address (Not mailing address) r- Flood j— Fire r Liq r Landslide FN/A Floor Suite No
Description of Work
Use F—Const Type s—
# Stories # Units (if Res)s
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Valuation goo
Material/Labor bor
New/Add SF� Remodel SF� Garage/New/Add �
OWNER'S NAME LastCFirst I L\,1.aS c'),�
Owner's Address Owner's E-mail Address
City State F— Zip F__ Telephone i 4y 4"jQ55fby
APPLICANT'S NAME Last i First
Applicants Address Applicant's E-mail Address
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City V' ✓ 6 i ao n State ` Zip q`Telephone "Ti q �Cv fgr;L�
ARCHITECT/DESIGNER'S NAME Last First F Lic. No. s--
Architect/Designer's Address ArchitectlDesigner's E-mail Address
City State F Zip F Telephonel—
--
ENGINEER'S NAME Last First F Lic Nos
Engineer's Address Engineer's E-mail Address
City State F_ Zip F_ Telephones
CONTRACTOR'S NAME/COMPANY A Lic.No. �3i4' i Class
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Contractor's Address Contractor's E-mail Address
City C" `7\0- State ��� Zip Telephonec{Lj444Z
SETBACKS REAR SETBACKS FRONT PERMIT NO.xMZ�.bM
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
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USE ZONE DEVELOPMENT NO rotu0DyWy PLAN CHECK FEES $