HomeMy WebLinkAboutXR2024-6790 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division
r Comm'I Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
wilding r Grading F-Drainage r Elec r Mech r Plum CuvdCut CuvdFill
Address (Not mailing address) F_ Flood r Fire r Liq r Landslide
z0g3Z
N
Remodel SF
ge/New/Addf
New/Add SF�— '� S 00
OWNER'S NAME Last Et-b�FWj Y
Owners Address
280� Gar-&- 61�e- zoA-D
City �' tzT (�¢fyG� f State
APPLICANT'S NAME Last I W 4 (
Applicant's Address
�I) 10 ` ,LCM/+/J s�
City /_ Me S,-i- State
rN/A Floor Suite No
I '
User—
Const Type s
# StoriesFT # Units (if Res)
Valuation $ 0 p0
Material/Labor
First I T-0
Owner's E-mail Address
Zip Telephony
C),0VAA-eA-1�(x
�2 393 i,�,'
First I `[' l,A...-H-
Applicant's E-mail Address
r�'l�#-G>J ����✓5-r0 w� • C� we
Zip ! Z 2- / Telephone
ARCHITECT/DESIGNER'S NAME Last First �— Lic. No. F—
Architect/Designer's Address Architect/Designer's E-mail Address
City State Zip F_ Telephoner—
ENGINEER'S NAME Last First F— Lic. NoF—
Engineer's Address Engineer's E-mail Address
City F— State r— Zip �— Telephoner—
CONTRACTOR'S NAME/COMPANY Lic. No. � / f � Class
SF'<Mt AS A t�PLtCwln/ �
Contractor's Address Contractor's E-mail Address
i
City
State F_ Zip �— Telephoner —
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEES $