HomeMy WebLinkAboutXR2024-6186 - Permit ApplicationPrint Form Worksheet for Combo Building& Solar Permit Application
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r Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F- Building r Grading F-Drainage r Elec r Mech
F- Plum Cu Yd cut cued Fill
Project Address (Not mailing address) r- Flood
r Fire r Liq F- Landslide F_N/A Floor Suite No
1,5 SI j
Description of Work
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Use F—ConstType
# Stories # Units (if Res)s
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F L s I tr
ia
J
IJ
New/AddSFRemodel SF Garage/New/Add
Valuation $
Material/Labo
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OWNER'S NAME Last S f� �` nP a i,�11
First I LO UE `mil
Owners Address
Owner's E-mail Address
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City State F
Zi Tele hone '
P P I�-�%��-s 4 �-
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APPLICANT'S NAME Last First yf (_U P, ) ,>j
/Address
Applicant's Address
Applicant's E-mail
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/JC u_)p p GUS _ rr. Gu�UT_?�7 9/[F*I L, C�
City / ) Lw op- rytxj :�;1 State ��
Zip �� � � Telephoned {^-- 1 I j
ARCHITECT/DESIGNER'S NAME Last
First Lic. No.
Architect/Designer's Address
ArchitecUDesigner's E-mail Address
City State F_
Zip F TelephoneF
ENGINEER'S NAME Last
First F Llc. Nos —
Engineer's Address
Engineer's E-mail Address
City State F—
Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY `- -77 y� 1 Lic. No. Class 57
Contractor's Address
Contractor's E-mail Address
City , 5,11) ��Ci P!-, j6, State
Zip Telephone
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SETBACKS REAR SETBACKS FRONT
PERMIT NO. xrL(�-
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $