HomeMy WebLinkAboutXR2024-5362 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application (6544
rjjComm'I FC4esidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) r Flood r' Fire r Li r Landslide rN/A Floor Suite No
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Description of WorkYe
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# StoriesF # Units (if Res)F
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Valuation $
Material/Labor �G
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New/Add SF �RawcdelSF
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OWNER'S NAME f�
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Owner's Address Owner's E-mail Address
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City «L� �G,� State C Zip `'�`r /7' Telephone l%9�— 71Z,�)-1��-7
APPLICANT'S NAME Last Tj A)C_ First I JAl
Applicant's Address Applicant's E-mail Address
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City /{�j�cuj,L�r,/,ry %S(�q�,�j� State Zip �� 'L Telephone
ARCHITECT/DESIGNER'S NAME Last %ur First /� X
ArchitectlDesigner's Address Architect/Designer's E-mail Address
City F State �— Zi -- Telephoned
ENGINEER'S NAME Last �— First �— Lic. No.
Engineer's Address Engineer's E-mail Address
City I State F Zip Fs Telephone F_
CONTRACTOR'S NAME/COMPANY_ 1Vic` Lic No. 5// Class —
Contractor's Address Contractor's E-mail Address
City (J��fl� //]/i State C Zip �7.a Telephone r/�/C;' t 1�
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $