HomeMy WebLinkAboutXR2024-6713 - Permit Application_Print Form Worksheet for Combo Building & Solar Permit Application y��� �R>
r Comm'I I� Residential City of Newport Beach - Building Division
7� NOTE: PLAN CHECK FEES DUE AT TIME OF,';[ IRMiTrai c.
XBuilding r Grading j-Drainage r- Elec r Mech
v
r Plum Cu Yd Cut F_Cu Yd Fill F_
Project Address (Not mailing address) C- Flood r Fire r- Liq r- Landslide rN/A Floor Suite No
Description of Work
Use fi-i,T ConstType
n
4
# StoriesF_ # Units (if Res)F
I /
Valuation $
Material/Labor L) [i i i
i
New/Add SF�— Remodel SF j.5 Garage/New/Add �—
OWNER'S NAME Last
First ;f•:r.is j ,s, t ,,
Owner's Address
Owner's E-mail Address
City F �Twf,>} It7t'r. to State (/t
ZI t7
P (_ L (p V TelephoneF_
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
City �— State r—
Zip �— Telephonel
ARCHITECT/DESIGNER'S NAME Last L f
;; n First ) -/ Lic. No.
Architect/Designer's Address
ArchitecUDesigner's E-mail Address
IFgS AVI J,t.
City I Crjs —c^, State Lit-
a
ZiP �(GC,Z �- Telephone %I I Zy`I
ENGINEER'S NAME Last
First �— Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City State F
Zip TelephoneF
CONTRACTOR'S NAME/COMPANY r Lic. No. jC� �•Z y Class l� j
2 yr
/,1/iC
f l
�n
Contractor's Address
Contractor's E-mail Address
City 1 L v V�' e, Ii, State F7
ZIP cj 7 e % L Telephone q � (;_- f) is
SETBACKS REAR SETBACKS FRONT
PERMIT NO. X_� ZQz y _ 6 I t 3
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $