HomeMy WebLinkAboutXR2024-6006 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F Comm'] F Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Plluilding r Grading
Project Address (�
Description of Work
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New/Add SF
OWNER'S NAME
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Cu Yd Cut Cu Yd Fill
I (— Flood j— Fire r Liq r Landslide rN/A Floor
Suite No
Use s ConstType s
(j,Rol # Stories # Units (if Res)[ —
Remodel SFF -- Garage/New/Add �—
Last I V / L h-
Owner's Address
City p(�-ti,��7�(f i2i� State Cpl
APPLICANTS NAME Last[...(
Applicant's Address
City �yi State
ARCHITECT/DESIGNER'S NAME
Last
Architect/Designer's Address
City
First
Owner's E-mail Address
Valuation $ Fi
Material/Labor
Zip ie(,b, Telephone �('(%
First iwl
Applicant's E-mail Address
Zip q VS O Telephone F T 1P3 -I'll
First F� Lic. No.
Architect/Designer's E-mail Address
State F— Zip F— Telephone
ENGINEER'S NAME Last
��L � -:--.ii7-'t First I Lic No. �7��,Q'
Engineer's Address Engineer's E-mail Address
quo L IV1041
City (Jt (�,� V ct e•..r State FeTc— ZiP (ZS%) Telephone (%0c1
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CONTRACTOR'S NAME/COMPANY n �N1�t�'a
Contractors Address
Z S�nI�S
City State fal
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
Lic No. (�-76 Classl b
Contractor's E-mail Address C j U'"1,$
Q(a I'bD I -W ZS
Zip ii126�� Telephone /(Y 7,35 7,17V
PERMIT NO. / `LL LL 4 / f t
PLAN CHECK NO,
PLAN CHECK FEES $