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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 -f , 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 \J PERMIT NO. \ (ten%4-000S SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO? G \w 10 USE ZONE DEVELOPMENT NO _ PLAN CHECK FEES $