HomeMy WebLinkAboutXR2024-6224 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application oy—g-wq
jomm'I esidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL �.,.o.•'
GB"uilding [- Grading [-Drainage [- Elec [- Mech [- Plum Cu vd cut Cu Yd Fill F
Project Address (Not mailing address) [- Flood [- Fire [- Liq [- Landslide [-N/A Floor Suite No
Ifll 7 G /vL-A� >Ll&)/�' o7l i � n i/�� .
Description of Work IkA %IAd,d z lnA' 6Av
/
Use-2/6-ConstType
z2rr
# Stories,"/- # Units (if Res)
-wit /z/ it iL IL i'L - ft 5 %2 2G
Z
Valuation
New/Add SFF 7Z- Remodel SF 57 Garage/New/Add �—
$ �� �,
Material/Labor /
OWNER'SNAME/r/�C to"st /%ZG'i/(JV' Y/�/'� ty First (j�✓I/'j 66; c�/j Ol2ill;(J/lr' /T/�S
Owner's Address Owner's E-mail Address
City �j2 L j�!r State A Zip ,2G�j7 Telephone /��-7[=
APPLICANT'S NAME Last % � 6/ /t iC First /A Y
Applicant's Address Applicant's E-mail Address
% y r
City lJAC f-7�-,I)A G j,^1jD State r Zip TelephoneF7
ARCHITECT/DESIGNER'S NAME Last�First jla(//� �/ Lic. No 21
Architect/Designer's Address Architect/Designer's E-mail Address _
�1
�d±2!1z A
City State -� Zip Telephone
ENGINEER'S NAME Last First 7— Lic. No.F!
Engineer's Address Engineer's E-mail Address
City State F Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY Lic. No. �— Class
Contractors Address Contractor's E-mail Address
City � State I— Zip F__ Telephoned
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $