HomeMy WebLinkAboutXR2024-6550 - Permit Application1_ P. Fc _m I Worksheet for Combo Building & Solar Permit Application
r Comm'I residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
r%6uilding r Grading rDrainage r Elec rMech
r Plum CuvdCut CuYdFill F_
Project Address (Not mailing address) r Flood
r Fire r Liq r Landslide r_N/A Floor Suite No
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Ir{t -
Description of Work
P
z
Use > Const Type
# StoriesF # Units (if Res)F_
4�°rEtt�mrnf
�e4'c7
Valuation $ �
Material/Labor �L
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New/Add SFF- Remodel SF tf�— G�rage/New/Add (vim
5
OWNER'S NAME Last � �_ f It
First "
Owners Address
Owner's E-mail Address
n'
n
city ��� _ ..z�q %GC Z� State y.� h
Zip `j ,' Telephone��
APPLICANT'S NAME Last
First T6,
Applicant's Address
Applicant's E-mail Address
04
City 1G- 4,t i-r-` State /414
Zip T 2; j Telephone t�t r 'j [i.. 17 J
ARCHITECT/DESIGNER'S NAME
-1 Last �'.. ,a� ;, (' First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City I State �—
Zip F Telephoned
ENGINEER'S NAME Last /4i r,
First 7 Lic. No.1�
Engineer's Address
Engineer's E-mail Address
City State F_
Zip F_ TelephoneF_
CONTRACTOR'S NAME/COMPANY Lic No. IF, ! t"r,. Class
Contractor's Address
Contractor's E-mail Address
Ce
City .)-e"4'nL State r;-4/�
Zip-t`',I.?i Telephone4F1'i
SETBACKS REAR SETBACKS FRONT
PERMIT NO. X(Z2_o24 - ( SS'C)
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $