HomeMy WebLinkAboutXR2024-0915 - Permit ApplicationPrint Form_ OV Worksheet for Combo Building & Solar Permit Application
r Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building r Grading r-Drainage F_ Elec
Project Address I
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Description of Work
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address) F_ Flood r Fire r Liq r Landslide rN/A Floor Suite No
Use FzConstTypeF
# Stories # Units (if Res)F_7 Valuation
New/Add SFr— Remodel SF .�`%/ Garage/New/Add F— Material/Labor T^
OWNER'S NAME Last�C FirstL s
Owner's Address
City ���G��G�� State
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APPLICANT'S NAME Last ? ,,Z'z 2 L -6,-z,
Applicant's Address
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City ��) jv ��'�!:L State Gs�
ARCHITECT/DESIGNER'S NAME Last
Architect/Designer's Address
City
Owners
E-mail Address
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Zip L 1y
Firsts/�'u�f
Applicant's E-mail Address
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Zip �/2� -?-7 Telephone q_;(,? - (o0,z- Z -7'5' L
First
Architect/Designer's E-mail Address
State F_
Zip I Telephone
Lic. No.
ENGINEER'S NAME Last First �'y�/G�� Lic. No.r-
Engineer's Address Engineers E-mail Address
City Jj5j/j�� /`!�7 State 77/�_ — Zip T/ TelephoneQ4j- jFb$-?20
CONTRACTOR'S NAME/COMPANY
Contractor's Address
City
SETBACKS REAR
SETBACKS LEFT
USE ZONE
Lic. No. F-- Class
Contractor's E-mail Address
State F___ ZipF Telephoned
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
PERMIT NO.
PLAN CHECK NO
PLAN CHECK FEES $
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