HomeMy WebLinkAboutXR2024-6773 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application
�mm'I [- esidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[-/Building [- Grading [-Drainage [-Elec j-Mech [- Plum Cu Yd Cutl Cu Yd Fill
Project Address (Not mailing address) f Flood [- Fire [- Liq [- Landslide [-N/A Floor Suite No
Description of Work /C-A i tt vZ �� 7P-A 1-Z3
Use _vConst Type 1/ %1
Stories�irJ # Units (if Res)u�
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Valuation $ Z n
Material/Labor �.
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New/AddSFF — RerNedetSF 6 �>` Garage/New/Add
OWNER'S NAME jC/ Jest �%� C I/�A/Uj�First 11 /�q PII9jC j `VG,I/ iG'iCf �%
Owner's Address
Ow/ner's E-mail Address
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City A; State Zip 97— _6 Telephone `7, - 7� ._
APPLICANT'S NAME Last First n f
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Applicant's Address Applicant's E-mail Address
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City (SAL/����G S L� �q,i, State Zip ;7/ ,� 2 Telephone
ARCHITECT/DESIGNER'S NAME Last I / Asl i First �h• �/ 6ic-No ;,6
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Arch itect/Designer's Address Architect/Designer's E-mail Address
City �— State �— Zip Telephone
ENGINEER'S NAME Last First Lic. No.F—
Engineer's Address Engineer's E-mail Address
City State �- Zip l a Telephone
CONTRACTOR'S NAME/COMPANY Lic. No. F Class
Contractors Address Contractor's E-mail Address
City State �— Zip F_ Telephoned
SETBACKS REAR SETBACKS FRONT PERMIT NO. VloZq + 773
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $