HomeMy WebLinkAboutPV2024-0003 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application 0�fWPOR>
F_Comm'I F_ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F_Building I- Grading j—Drainage F_ Elec r Mech
r Plum CuYdCut s CuvdFill
Project Address
(Not mailing address) Flood
F_ Fire r Liq r Landslide f N/A Floor Suite No
Description of Work
r
Use s ConstType F—
# Stories # Units (if Res)s
Valuation II G
Material/Labor I
New/Add SF F_Remodel SFsi Garage/New/Add �—
OWNER'S NAME
Last f r��f ht'ht l4i,i--�
First
Owners Address
Owner's E-mail Address
4.1'e
41 ty�Ll irtl�C r LC,n•"l SL Ivl rCcy"
City f ,irk t t
c, CGS State C-I /,
Zip C Telephone �._�v��' i. r�fC
I2 c
APPLICANT'S NAME
Last CL
First "
Applicant's Address
Applicant's E-mail Address
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,
City - f f <
State Zip
77 Telephone r71t/ -- rY) 7-6 � 1L-�'
ARCHITECT/DESIGNER'S NAME Last First
i� Lic. No.
', / �r i
t
,�f ., t
Architect/Designer's Address
Architect/Designer's E-mail Address
City l- r ' % If C- State / 0 Zip �!r S Telephone -j S 1 _ `f K` -')76, 9
ENGINEER'S NAME
Last
First I Lic. No.s
Engineers Address
Engineer's E-mail Address
City
State F_ Zip F_ TelephoneF_
CONTRACTOR'S NAME/COMPANY
Lic No. r/?3?jI Class
Contractors Address
Contractor's E-mail Address
J ,
City I --F
c/i ,�
State E�!t Zip Tj Telephone � r y_. z �i - 3ci0 ,
SETBACKS REAR
SETBACKS FRONT
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PERMIT NO. \ (ten%4-000S
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO? G \w 10
USE ZONE
DEVELOPMENT NO _
PLAN CHECK FEES $