HomeMy WebLinkAboutXR2024-6891 - Permit ApplicationN1v7''e/R
Print Form_ Worksheet for Combo Building & Solar Permit Application EWPoa�
City of Newport Beach - Building Division o4
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Project Address (Not mailing address) F_ Flood r Fire i- Liq F_ Landslide rN/A Floor Suite No
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Description of Work %?i )10 AZej,, j/a. /p,x, 7F i'0 t
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# Stories T # Units (if Res)F
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Valuation $ Lw.
Material/Labor
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New/Add SF SF Gara a/New/Add �—
OWNER'S NAME/Gf7C �/zdiN�4;I% ,
Owner's Address Owner's E-mail Address
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City F 12- i 7 ,1v r State C A Zip j � •7 Telephone 72
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APPLICANT'S NAME Last l? (/R ix First A /
Applicant's Address Applicant's E-mail Address
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City 7S7/n>%) State �p — Zip TelephoneF�7l j- 2e -
ARCHITECT/DESIGNER'S NAME Last /2- Af+t/ i e j2 % First 747,r Lic. N . '- Z/4 _Z7
ArchitecUDesigner's Address Architect/Designer's E-mail Address
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City State ip Telephone
ENGINEER'S NAME Last First F— Lic. No. -
Engineer's Address Engineer's E-mail Address
City I StateF__Zip F— Telephone�—
CONTRACTOR'S NAME/COMPANY Lic. No. �— Class[
Contractor's Address Contractor's E-mail Address
City State �— Zip F Telephoned
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SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $