HomeMy WebLinkAboutXR2024-0363 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application
j-i Comm'I rvnesidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) F_ Flood F_ Fire i— Liq (— Landslide rN/A Floor Suite No
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Description of Work % //I �% AN1,
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# Storiesr__51 Units (if Res)�7j
Valuation
Material/Labor•
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New/Add SF� Beaaedef SF %��LP Garage/New/Add
OWNER'S NAME Last Co First
Owner's Address Ow - all Address
City State Zip F TelephoneF�
APPLICANT'S NAME Last First �7J
Applicant's Address _ Applicant's E-mail Address
City /J/=i�%A //�C�Q f] State P Zip �l�Z Telephone ��
ARCHITECT/DESIGNER'S NAME Last JL,ilV i 17,j7- First Lic. N . _- ?22 q 1�
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Architect/Designer's Address Architect/Designer's E-mail Address /
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City State — Telephone
ENGINEER'S NAME Last First Lic. No.1
Engineer's Address Engineer's E-mail Address
City I State r-- Zip TelephoneF_
CONTRACTOR'S NAME/COMPANY Lic No. �— Class F
Contractor's Address Contractor's E-mail Address
City State F_ Zip I TelephoneF
SETBACKS REAR SETBACKS FRONT PERMIT NO.ZaL'i-0363
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. �ZOZ`l• 03
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $