HomeMy WebLinkAboutXR2024-0894 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
r Comm'I (- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTA
1 esuilding r Grading rDrainage r Elec r Mech r Plum cuvdCut F cuvdFill F
Project Address (Not mailing address) F_ Flood f Fire f Liq f Landslide rN/A Floor Suite No
Description of Work
tV � sS Ll e-
Use F Const Type F
_
# StoriesF_ # Units (if Res)[—
$
Valuation— Material/Lab
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New/Add SFRemodel SF �— Garage/New/Add �
OWNER'S NAME Last
t/
O `S-First
Owners Address
Owner's E-mail Address
city ;. Ce:---_
State
Zip q��,�j Telephone q,q �7�6,_ �-r (o 0
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
3, 0 c c
City I N `27
State C /- Zip I-t �e(a 3 Telephone I '-V(, d . L'L O
ARCHITECT/DESIGNER'S NAME
Last First— Lit. No. F—
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
City I
State �— Zip [_ Telephoner�
ENGINEER'S NAME LastLII
First LLiic N�o.F—
Engineer's Address
Engi eeT is E-mail Addres
Ci Na4
State-t 7,P9�-�r� F� Te}aphaa i i
CONTRACTOR'S NAME/COMPANY
�_"j _ � Lic. No. �q (a ) ciq Class
Contractor's Address
Contractor's E-mail Address t
City
State �— Zip Telephone ` y_ -� , .Z c)
/
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. Lo R
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES