HomeMy WebLinkAboutXR2024-7071 - Permit Applicationorm_._j Worksheet for Combo Building & Solar Permit Application o�`
Jmm'I �sidential City of Newport Beach - Building Division 6
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Y G
wilding r Grading F-Drainage I— Elec F_ Mech r- plum Cuyd Cut F_Cu Yd Fill F_
Project Address (Not mailing address) F Flood j- Firer Liq r Landslide rN/A Floor Sul
I
C /��i S— �✓Ui� Ill
. 91Q7 I'
Description of Work LG ,�r7pL %�., -- ��f5 1�Yt
-�� r
Use 6, Const Type I V
/'j _
/
# Storiesw # Units (if Re
Valuation$ ���y
Material/Labor 2/ C o
%
New/AddSF_ �l�'
&s�OdgfSF'7 Garage/New/Add �—
OWNER'SNAME/CAG -Last-4.. i/✓/
Owner's Address
Owner's E-mail Address
� mil c G}7� ` J
•211- e�C /J C� II, vi GIe 6'0 /�L 7%�'GS�;r C'L
City 112-VI&Z State !t Zip 7Z(, l.7 Telephone
APPLICANT'S NAME Last First
Applicant's Address
Applicant's E-mail Address
c ClU'������.. C�OdK
City � LGO 4 `S "'U D State CA Zip Tele hone _ c
�6� z p
ARCHITECT/DESIGNER'S NAME
Last i . / First IZ iJ 11 :'Dx Lic. N��
Architect/Designer'sA//ddress Architect/Designer's E-mail Address
City a e Telephone
ENGINEER'S NAME Last First F—Lic. NoF—
Engineer's Address Engineer's E-mail Address
City I State F_— Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY Lic. No. [ h / s r
� � �/
�
Contractor's Address Contractor's E-mail Address
City F_ State I Zip F_ TelephoneF�
SETBACKS REAR SETBACKS FRONT PERMIT NO..L,�2 '� p
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO USEZONE DEVELOPMENT NO PLAN CHECK FFFC a