HomeMy WebLinkAboutXR2024-6657 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
r Comm] XResidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building rGrading
r—Drainage j—Elec j—Mech
rPlum Cu Yd Cutl Cu Yd Filll
Project Address (Not mailing address) I— Flood
r Fire j— Liq r Landslide rN/A Floor Suite No
2-11 R SiriZvu:��-\
r i
Description of Work
Use a-Z�U' ConstType V ii
# StoriesFT # Units (if Res)F_
Valuation $ $ C
Material/Labor .A`)
New/AddSFF— Remodel SF izs_ Garage/New/Addlr
OWNER'S NAME
Last �— First
Owners Address
Owner's E-mail Address
City
State
Zip F— TelephoneF_
APPLICANT'S NAME
Last
First
Applicant's Address
Applicant's E-mail Address
City I
State �—
Zip F Telephoned
ARCHITECT/DESIGNER'S NAME Last �
First F_ Lic. No. F_
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State F
Zip F_ Telephonel—
ENGINEER'S NAME
Last �—
First F Lic. No. F—
Engineer's Address
Engineer's E-mail Address
City
State I
Zip Telephone)
CONTRACTOR'S NAME/COMPANY
Lic. No. �— Class
Contractor's Address
Contractor's E-mail Address
City
State �—
—
Zip F Telephonel
SETBACKS REAR
SETBACKS FRONT
PERMIT NO. �Crizo2 y— 6657
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $