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HomeMy WebLinkAboutXR2024-6610 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application r Comm'I j— Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL rBuilding r Grading F-Drainage [_ Elec r Mech r Plum CuYdCut F__ CuYdFill F— Project Address (Not mailing address) r— Flood r— Fire F Liq r Landslide f N/A Floor Suite No 3 0 � %Qx;r�) oO ack lima,/ CA G Z G 25 F F— Description of Work Use � ConstType _ # Stories # Units (if Res)F \c�at,�., Cyr i1 b�-F�\dw,� doo: sAw.e S:2e. , New/Add SFoo � ,� Remodel SF �— N Garage/New/Add iV % /i valuation $ Material/Labor Ps, OWNER'S NAME Last First % < .ate Owner's Address Owner's E-mail Address 3Q8 Mop 3o1c� ave Co„ •,� 6A Mp ov city ca (ova Ah \ M c,f State �' ; Zip F Z us Telephone G Wr EM %I'A APPLICANT'S NAME Last (�hlT,, O Z First A O Applicant's Address Applicant's E-mail Address 2 3 b S Z U' (-_j �ob� W01A �C ii AA �I©(?� City 1�<<u U.ern ^^ State �t`( ZiP QZGQ( Telephone3n 2,,z 1`f�3 C:,•, ARCHITECT/DESIGNER'S NAME Last �— First F Lic. No. ` Architect/Designer's Address Architect/Designer's E-mail Address City State �— Zip F TelephoneF_ ENGINEER'S NAME Last First F Lic. No.F Engineer's Address Engineer's E-mail Address City State F Zip F Telephoned CONTRACTOR'S NAME/COMPANY ,avhLic No. Pq \OG Class S�cC�sv,C Co�,S�v�C� oh Contractor's Address Contractor's E-mail Address a City I rl < S S �w �l _ O State (, Zip 6 2 C, 0, 1 Telephone "� ? 2 Lei 3 S c C`o`ti SETBACKS REAR SETBACKS FRONT PERMIT NO. l lw \_ rd SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $