HomeMy WebLinkAboutXR2024-0450 - Permit ApplicationPrint Form J Worksheet for Combo Building & Solar Permit Application (51
°�r Comm'I �( Residential City of Newport Beach -Building DivisionNOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL ,.+
rBuilding F_ Grading r-Drainage r Elec j—Mech
j— Plum CuYdCut l b CuvdFill �.
Project Address (Not mailing address) r Flood
r Fire r Liq r Landslide f_N/A Floor Suite No
9S� sAN�� «
F- F—
Description of Work
Use F/t ConstType I I/-J
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# Stories[ / #Units (if Res)r!
sFx + 1 i34'i1h
Valuation$ Fq-�4,,cwo
Material/Labor
New/Add SF 9 7 �` Remodel SF S�Q Garage/New/Add F
OWNER'S NAME Last vtv
First 7/1 So k
Owner's Address
Owners E-mail Address
95¢ s�aN�c�ts rt- pK= — _— -
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City State
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Zip Telephone ��Gr _2 $�� SS/
APPLICANT'S NAME Last el SE
First
Applicant's Address
Applicant's E-mail Address
S72 E. cv/fiT A/t✓Y) sV)7-F
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City ei>11 t State I"—
Zip q 7, 7 Telephone q¢i- ?7
ARCHITECT/DESIGNER'S NAME Last 6)4 - First— Lic. No. C- 34 ¢4
Architect/Designees Address
ArchitectlDesigners E-mail Address
City I State F—
Zip �— TelephoneF
ENGINEER'S NAME Last I �y/Q,S,5�,$ First 7
Engineer's Address
Engineers E-mail Address
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City s AA. 7.4 � A)A State
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ZIP �i 2 7 0, Telephone �f � f Q 3 S. 2 g"r70
CONTRACTOR'S NAME/COMPANY 7-j6 D
Lic. No. F_— ClassF_
Contractors Address
Contractor's E-mail Address
City State F—
Zip F TelephoneF—
SETBACKS REAR SETBACKS FRONT
PERMIT NO.W7,ly1- 0vso
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. Z • 0
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $
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