HomeMy WebLinkAboutXR2024-6813 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application of?°°
r/tomm'I ft,4esidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL u
,Building rGrading
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Project Address (Not mailing address) Flood r Fire r Liq I— Landslide F_N/A Floor Suite No
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Description of Work /jteG_/, [3xJr��� jyrli
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# Stories #Units (if Res)
Valuation
Material/Labor /
New/Add SF�
ReISF SF Garage/New/Add F—
OWNER'S NAME IC•
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Owner's Address
O/Owner's E-mail Address
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City
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State �� Zip " i ? Telephone -7'w •
APPLICANT'S NAME
Last 772U A x First Y
Applicant's Address
Applicant's E-mail Address
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State Zip GJ2Telephone o% j 7c:7
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ARCHITECT/DESIGNER'S NAME Last I R-AA11 Pr_,;Z_ First Lic N
Architect/Designer's Address
Architect/Designer's E-mail Address
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City
Zip �— Telephonel—
ENGINEER'S NAME
Last First F Lic. No.[ —Engineer's
Address
Engineer's E-mail Address
City I
State �— Zip F_ TelephoneF_
CONTRACTOR'S NAME/COMPANY Lic. No. F-- Class
Contractor's Address
Contractor's E-mail Address
City
State F_— Zip F Telephoned
SETBACKS REAR
SETBACKS FRONT PERMIT NO. XRZ62q - 6 113
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $