HomeMy WebLinkAboutXR2024-6443 - Permit Application__Print Form 1 Worksheet for Combo Building & Solar Permit Application@6C,4jQP*,,,
"°City of Newport Beach - Building Divisiont
r Comm'I Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL_.
rBuilding r Grading
v
rDrainage r Elec F_Mech r Plum CuvdCut F CuYdFill F_
Project Address (Not mailing address) Flood r Fire f Liq r Landslide �N/A Floor Suite No
71 / i/ (f L/ i Alold F— �—
Description of Work
Use Const Type
11A w Q Acia 4 t
A , Alfb/ Het, er
# StoriesF # Units (if Res)
t/ V
Valuation $
Material/Labor
New/Add SFF
Remodel SF F— Garage/New/Add F—
OWNER'S NAME
Last j 511AdNe2 First C' AF l o.
Owner's Address
Owner's E-mail Address
7 11 �jkLtauP0
City I JU ()
State C/k Zip 9TelephoneF—
i f
APPLICANT'S NAMES
Last / \ � Vim i(�r First I (' I Ad
Applicant's Address
Applicant's E-mail Address
Sk.k
4- 1 �( ivgS wipbu)'(dow(
:ity nJ 1�
State C Zip 1 � O6,S Telephone 9'-JCf �679
ARCHITECT/DESIGNER'S NAME Last First
Lic. No. F_
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
City I
State F Zip F— Telephone[ —
ENGINEER'S NAME
Last S K U_pLAr D S C-1— First ff(AS D V) Lic. No. C617 2
Engineer's Address
Engineer's E-mail Address
City
State F— Zip F— TelephoneF_
CONTRACTOR'S NAME/COMPANY 1 —r 13U/' 1 /r � Lic. No. � a Class?
7� /fit
Contractor's Address
Contractor's E-mail Address
City
State I Zip F Telephoned
SETBACKS REAR
SETBACKS FRONT PERMIT NO$AN/Z4* 6 3
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $