HomeMy WebLinkAboutXR2024-6662 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application O EW PORb
F_ Comm'I r Residential
City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building r Grading F-Drainage r Elec j— Mech r Plum CuYdCut Cuyd Fill F
Project Address (Not mailing address) F_ Flood r Fire r Liq r Landslide rN/A Floor Suite No
Cp,�—
Description of Work
Use s ConstType F_
1 S r2C A^ S y
# Stories # Units (if Ress
Aen10
Valuation $
Material/Labor $ p 00
i
New/Add SF�— Remodel SF Garage/New/Add �—
OWNER'S NAME Last ShC' k2��
Y' First C.0.r0
Owner's Address Owner's E-mail Address
C.om
Ci[y�_r� � State C� Zip C1Z(O(O0 Telephone �(Q q L}qt�
APPLICANT'S NAME Last First
So_me�
Applicant's Address Applicant's E-mail Address
City State F Zip F_ Telephoned
ARCHITECT/DESIGNER'S NAME st First Lic. No. F—
ArchitectlDesigner's Address G�3.chitect/Designer's E-mail Address
City State �— Zip Telephonel—
ENGINEER'S NAME Last �— First Lic No. F__
Engineer's Address Engineer's E-mail Address
City State F— Zip Telephoned
CONTRACTOR'S NAME/COMPANY Lic. No. �— Class F_
Contractor's Address Contractor's E-mail Address
City State F_ Zip F_ Telephone
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SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $