HomeMy WebLinkAboutXC2024-0122 - Permit ApplicationPrint Form_ I Worksheet for Combo Building & Solar Permit Application
r Comm] r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
f—Building F_ Grading rDrainage rElec
Address (Not mailing
6 �20 /,V&l:_)
of Work
New/Add SFF— Remodel SF
r Mech r Plum Cu Yd Cutl Cu Yd Fill F_
I— Flood I— Fire r Liq F_ Landslide [_N/A Floor
Suite No
I
Use F— ConstType
# StoriesF_ # Units (if Res)F_
Valuation $
Garage/New/Add F— Material/Labor
OWNER'S NAME Last I First
Owner's Address Owner's E-mail Address LA
City I State Zip F_ Telephone[
APPLICANT'S NAME Last
First
Applicant's Address Applicant's E-mail Address
City I State F___ Zip F__ Telephoned
ARCHITECTIDESIGNER'S NAME Last
First Lic No.
Architect/Designer's Address Architect/Designer's E-mail Address
City I State I Zip F TelephoneF
ENGINEER'S NAME Last First
Engineer's Address Engineer's E-mail Address
City State F___ Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY
Contractor's Address
�"�9E� C64�✓��
City � �U/� -C
SETBACKS REAR
SETBACKS LEFT
Lic. No.F--
S Al yll) ,el� �i�h/6 51 vim% Lic. No. /p/i/8_ Class LGC.
Contractor's E-mail Address
State &;; Zip R�4/y TelephoneFyf-79p'5So-e-,
SETBACKS FRONT PERMIT NO. XC 2�Lj — 0I 2Z
SETBACKS RIGHT PLAN CHECK NO. ec_2e2�f
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $