HomeMy WebLinkAboutXR2024-0101 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application O4IEWPoRt
Comm'[ Residential City of Newport Beach -Building Division �,M_ $_
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL `",�ow�'
j $uilding [Grading r-Drainage rElec F_Mech
r-Plum Cu vd Cut Cu Yd Filll
Project Address (Not mailing address) F_ Flood
i _ Fire r Liq r Landslide FN/A Floor Suite No
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- l5 YUwi,l V _Q�_c cV/Vl--ft r(A,L _ �y n via Gl-et__
Description of Work
Use Const Type
-
# StoriesF_ # Units (if Res)
(
(,� v
' V /
- -
Valuation $
Material/Labor Fop"*
New/Add SFi� Garage/New/Add F
OWNER'S NAME Last �jVCAVFT
First W9 ( p SVwu l v 4ectw t
Owner's Address
Owner's E-mail Address
�(YOO VOVA V,,WVVC 111 AV'C, 40D
(�e�°bje3?a5®�YV1Gt (I .cow
City IVUIlie State r
Zip / LLat2 TelephoneU0I—�515
APPLICANT'S NAME Last
First �,l av� V1 M
Applicant's Address
Applicant's E-mail Address
3l"1 _4 V1x�ti,�� Sv tie 1�3
�� rtivivtr� G�Cwt� (�(� • Corn
City S JIAT,� r-} r�{�l) State �
Zip qT P_7 Telephone 0[14q (3--78 0
ARCHITECT/DESIGNER'S NAME Last e First I f VA(J/V lC C ZZL U 2-
Lic. No.
Architect/Designer's Address
ArchitecdDesigner's E-mail Address
Z0100 Ws l S+.
ryl V a1_k Co
City � t YVtx o State I Vr
—(f°I(9
Zip P%2L9 Telephonel CfgCj 91S - b 12-3
ENGINEER'S NAME Last V'1 VV� First Lic. No. ci S 5 (p
Engineer's Address
Engineer's E-mail Address
Ui�O C1��r�anrr — �ti4eZDv
aG2t }a tW_!(�IFN41+> NCtN
City l �U e State ((�
Zip �T y(k l Ali Telephone (0 LI 227 I S, P
CONTRACTOR'S NAME/COMPANY r �� /����� I Lic No. F— ClassF
G I
Contractor's Address
Contractor's E-mail Address
311)w PA v(r,D y(o
by cP
City call ,)� C fA,l/.i�1-(r01/1.C) State F
Zip p� 2-P��j Telep one qqe 3 10— 0717 6
SETBACKS REAR SETBACKS FRONT
PERMIT NO. X l
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. •
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $