HomeMy WebLinkAboutXR2024-0273 - Permit ApplicationI Worksheet for C`o bo Building & Solar Permit Application ,F EUP°rm
F-i4reeidential City of Newport Beach - Building Division l
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Description of Work
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# Stories ;� # Units (if Res)�1j
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Valuation $
Material/Labor ��/•
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OWNER'S NAME Last '%/-f?' 11'24�I/First
Owners Address Owner's E-m ' ss
City �- State Zip Telephone[—
APPLICANT'S NAME Last X First fi \�
Applicant's Address Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last PZ- ft/t` i %
/G% First �AVdl Lic No •Z`Sm
ArchitecVDesigner's Address Architect/Designer's E-mail Address
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City 'State TelephoneF—
ENGINEER'S NAME Last r— First �— Lic. No.F—
Engineers Address Engineer's E-mail Address
City �— State �_ Zip F_ Telephone[ —
CONTRACTOR'S NAME/COMPANY Lic No. F— ClassF-
Contractor's Address Contractor's E-mail Address
City F— State �� Zip F_ Telephone(-_--
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SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 7
USE ZONE DEVELOPMENT NO PLAN CHECK FEES S