HomeMy WebLinkAboutXR2024-0031 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
r Comm') I� Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building r Grading (-Drainage rJElec r Mech
Project Address (Not mailing;
SIo GURU I,�ta Dr.
Description of Work
(Just !
o• ,, / l 'ITY1",' ll
..
Cu Yd Cut Cu Yd Fill
j- Flood r Fire r- Licl r
RemodelSFr- Garage/New/Add
OWNER'S NAME Last �i,, n
Owner's Address
Slo cUfi(^I;^ta
City I AJC,)P d r✓FOCI, State F77
APPLICANT'S NAME Last
Applicant's Address
Vto V;r ij:rt ,a p1
City C i7!' e,0 State F
ARCHITECT/DESIGNER'S NAME
Last
Architect/Designer's Address
o 7 U l r,-o n
city Los }U M nsU State Fc 4
ENGINEER'S NAME Last
0l;tjeZ
Engineer's Address
1U- A ✓Cnlovn Blvd.
POt#. z.ZsN
City � ; rn ; ro 4 f 'h� State C -4
�l
CONTRACTOR'S NAME/COMPANY
Contractor's Address
City Fcos �v m.elso
SETBACKS REAR
SETBACKS LEFT
USE ZONE
First
N/A Floor Suite No
Use ConstType
# Stories[ # Units (if Res)F—
Valuation $
Material/Labor F
%' CA,
Owner's E-mail Address
Zip Z. 6 E 3 Telephone Cj Lj ci Z Z7 70,50
First I G I U; s
Applicant's E-mail Address
G'IV;S4ft..(7)1JO^,Cort
Zip q Z E, 1-'7 Telephone 31 CC13 S 6 Z Z 9
First - 1 U, S Lic. No, F —
Architect/Designer's E-mail Address
OIVISP Cje,11d, poC.Gay
Zip GZbZ7 Telephone 3lo'g3S ez2c)
First F71 ci0 t C/o Lic. No. C 76372
Engineer's E-mail Address
Ccer P. ccstr�,,J 11u1®�r
ZIP go74y Telephone 31Oge7 1'112-
CNc it Do 7e �, ICJ, �� Qnc:�>7 Lic. No. hy0771 classF
Contractor's E-mail Address
^iioL wglldovleOC-�
State (, A Zip FT Telephone 69 ?.-4
6P.90
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
PERMIT NO. XRZoZ'��
PLAN CHECK N0.Q'lI+•
PLAN CHECK FEES $