HomeMy WebLinkAboutU2024-5290 - Permit ApplicationPrint Form -Worksheet for Combo Building & Solar Permit Application
F Comm'I residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding rGrading rDrainage FElec rMech rPlum CuvdCut CuYdFill
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ect Address (Not mailing address
of Work
r Flood (- Fire r Liq r Landslide I - N/A Floor Suite No
New/Add SF1_— Remodel SFF-- Garage/New/Add
OWNER'S NAME Lastl -t��� First)
Use F—ConstTypeF_
# StoriesF_ # Units (if Res)F_
Valuation$ .� �t ( ;._'_"
Material/Labor
Owner's Address Owner's E-mail Address
City y L �l G_ La`_, & State 77 Zip ` \0..{''t � Telephone
APPLICANT'S NAME Last 1 ` ; \ `j L� l � o First V-0 --\-c
Applicant's Address 1 Applicants E-mail Address v`,_ State eioneCity�("
lV �o3Mv�✓�jF�CCv C�1YXK�i I,
ARCHITECT/DESIGNER'S NAME Last
Architect/Designer's Address
City F--I.:. C' \-1 .Y-` �` ,�.�..i State F7
First ��.L% \ 6 Lic. No.
Architect/Designer's E-mail Address
Zip (.a/I ,� ( Telephone �,,- , ,-
ENGINEER'S NAME Last First
Lic No.F—
Engineer's Address Engineer's E-mail Address
City State F— Zip I— Telephoned
CONTRACTOR'S NAMEKOMPANY `� , i Lic No (v`� v, Class 71
Contractors Address Contractor's E-mail Address
City I\_(L\� \; 1. (o' C j:al.( �h State Zip lJ( i:., Telephone ',� �. 11/ l; 1
SETBACKS REAR
SETBACKS LEFT
SETBACKS FRONT
SETBACKS RIGHT
PERMIT NO.
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $