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HomeMy WebLinkAboutXR2024-0364 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application O` EW GOy6 V�,i`omm'I residential City of Newport Beach - Building Division � ) NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL I•'tsuilding r Grading j—Drainage r Elec r Mech r Plum CuYdCut F_ CuvdFill F_ Project Address (Not mauling address) r Flood r Fire r Liq r Landslide rN/A Floor Suite No ;�r Description of Work jC 7f � ✓�nttr+/t�¢ f y[r4rj674/ Use*7�71,� ConstType # Stories # Units (if Res)[ / �j /,�� Ax �� l� _ �/L�J j � � ApaQ Valuation $Z�l Material/Labor cz ZZO N New/Add SF� fiawgdel SF 5r Garage/New/Add r — OWNER'S NAME La4//�P`,/w� Co First Owner's Address Owner's E-mail Address___--''—`� City State Zip Telephoned APPLICANT'S NAME Last First J,q v Applicant's Address Applicant's E-mail Address "k �lz_ t/� •fC'Aewe _(�' [ dG : rd AYr City /JAGS 01 /QC,A—�� Stater Zip e1,�yZ Telephone � "-- ��t-- ARCHITECT/DESIGNER'S NAME Last ���j//� First /A t/Lic. N r!'f'ZZ,5_ Architect/Designer's Address Architect/Designer's E-mail Address � City 1 — Zip TelephonenL ENGINEER'S NAME Last �— First F_ Lic. No.F-- Engineer's Address Engineer's E-mail Address City State I---- Zip F_ TelephoneF_ CONTRACTOR'S NAME/COMPANY Lic No. �— Classr� Contractor's Address Contractor's E-mail Address City State Zip I Telephoned SETBACKS REAR SETBACKS FRONT PERMIT NO. ���✓��- 036 SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $