HomeMy WebLinkAboutXR2024-1207 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application o�''e
( Comm'I r Residential City of Newport Beach - Building Division£ '
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F_Building j-Grading rDrainage rElec rMech
r•Plum CuydCut s CuYdFill
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Project Address (Not maailing address) F_ Flood
r Fire r Liq r- Landslide FN/A Floor Suite No
Description of Work
Uses Const Type s
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# Storiess #Units (if Res)s
Valuation$CGj0
Material/Labor t •�
New/AddSF� RemodelSF� Garage/New/Add-
OWNER'S NAME Last 100 El /cf � t PC,First POP-7- �_ W �JA_FI €I)T S
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Owner's Address
Owner's E-mail Address
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City k�,w_tC`�-7 6' C State � /"")
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zip 9 i � Telephoned
APPLICANT'S NAME Last
First 6 rq/V 1
Applicant's Address
Applicant's E-mail Address
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City bd ()/ State F! I
Zip yg /1 , Telephone C7 j rj l ".� zz—q ,3 C1 /
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ARCH ITE,CCT/DE`SSIGNER'SNAME Last Firstr Lic. No. �—
Architect/Designer's Address
Architect/Designer's E-mail Address
City State F_
Zip F— Telephones
ENGINEER'S NAME Last OP 1 -2
First 7fj Dq 4 P!.7 C ' Lic No.s
Engineer'rr's Address
Engineer's E-mail Address
City �J�L, u State
Zip j 6 } Telephone C7 t
CONTRACTOR'S NAME/COMPANY g l n �y � Ll-otv T- yt W,7tNt W , Lic. No. J�F,,6,0 Class
V 1
Contractor's Address
Contractor's E-mail Address
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, r1 rccerr-51 Ic- CO-,
City071911 State L_' I
Zip Telephone C7 r' )'�7Z Z-
SETBACKS REAR SETBACKS FRONT
PERMIT NO. X" Z44- Imoj
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $