HomeMy WebLinkAboutXR2024-0706 - Permit ApplicationPrint Form_ Worksheet for Combo Building & Solar Permit Application a
It omm'I rLR�sidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building rGrading rDrainage I—Elec FMech rPlum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) r Flood r Fire j— Liq r Landslide F_N/A Floor Suite No
Description of Work h-lq % / 2E 1tZ7./f
Use ConstType v`—%
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# Stories # Units (if Res)I 7
Valuation $
Material/Labor 2/ 7a
New/Add SFF itmat1eISF 5j- Garage/New/Add �—
OWNER'S NAME IC -AC / %`�—�j'/N G�.I/%•��j�/` 41W Z7— 11 l -
Owner's Address Owner's E-mail Address
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City /%�G-%/(/ State
Telephone vI Zip '�j�7
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APPLICANT'S NAME Last Z First Ay
Applicant's Address Applicant's E-mail Address
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City (•_ y�rZ / '�Oiq�FY ��tJ� State �L A Zp � 2 ,!;� L Telephone
ARCHITECT/DESIGNER'S NAME —
Last �j (�f J //�/ First l 1�' Lic. No _ 22S_
ArchitectlDesigner's Address Architect/Designer's E-mail Address
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City �— State Imo--- p-F7— Telephoned
ENGINEER'S NAME Last First F__ Lic. No.1—
Engineer's Address Engineer's E-mail Address
City �— State I Zip �— Telephone[
CONTRACTOR'S NAME/COMPANY Lic. No. �— ClassF
Contractor's Address Contractor's E-mail Address
City I— State F_— Zip F_ Telephoner
SETBACKS REAR SETBACKS FRONT PERMIT NO. Y, A2_0& — 07()
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. Fcuz 4 - U 5 7 q
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $