HomeMy WebLinkAboutXR2024-6714 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application O�EWFpR9
[- Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL G,
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Project (Not mailing address) [- Flood
[- Fire [- Liq [- Landslide [-N/A Floor Suite No
/Address
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Description of Work
Use ConstT e V
# Stories #Units (if Res)
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New/Add SFF Remodel SF (p Garage/New/Add
Valuation $ }t. 2 / `)
Valuation $ or 'Ij}f �
OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
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City I�.,r he �� State i�—
Zip (_%G TelephoneF—
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
City State r
Zip TelephoneF
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designe//r's Address
Architect/Designer's E-mail Address
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city C cS�a rlt5,� State (,A
Zip I j Telephone 911 Ti -u-40
ENGINEER'S NAME Last First F Lic. No.1—
Engineer's Address
Engineer's E-mail Address
City State F__
Zip
NAME/COMPANY f� Lic. No. �Cf ,2 21 J Class TT
Contractor's Address
d Contractor's E-mail Address
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City tlt v , } �,,, .,� State a
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Zip c(.,t � , Tele hone `� '
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SETBACKS REAR SETBACKS FRONT
PERMIT NO. x ZzOZL1 — 6 1 I Y
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $