HomeMy WebLinkAboutXR2024-6655 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F Comm'I Residential City of Newport Beach - Building Division ®�
NOTE: PLAN CHECK FEES DUE AT TIME OF SI IRMITTAI c..
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XBuilding r— Grading j—Drainage r Elec I—Mech r Plum Cu vd Cut F_Cu Yd Fill F_
Project Address (Not mailing address) I- Flood ' Fire r Liq r Landslide rN/A Floor Suite No
g0(A1) "�IVJ
F 1 1
Description of Work
Use z U Const Type - ��
�C yr j)f wujj (.)ct- kr- 4.kt
# Stories # Units (if Res)F
Valuation$/
New/Add SF� Remodel SF 12.5 FGarage/New/Add
Material/Labor I t C'
,
OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
City F State �— Zip F—Telephonel
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
City State
—
Zip �— Telephonel
ARCHITECT/DESIGNER'S NAME Last �—
First —Lic. No. �—
Architect/Designer's Address
Architect/Designer's E-mail Address
City State F
Zip F— Telephone
ENGINEER'S NAME Last �—
First I— Lic. No. F—
Engineer's Address
Engineer's E-mail Address
City State �—
Zip F_ Telephone
CONTRACTOR'S NAME/COMPANY
Lic. No. F Class
Contractor's Address
Contractor's E-mail Address
City I State �—
Zip �— Telephone
�—
SETBACKS REAR SETBACKS FRONT
PERMIT NO. X 61 ZOZ l — 66_6
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $