HomeMy WebLinkAboutXR2024-5614 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
7�1!0mm'I UAesidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
� uilding r' Grading j-Drainage j- Elec r Mech
►- Plum Cu Yd Cut —- Cu Yd Fill
-ruit!ut iip ress (not mailing address) I— Flood F Fire F_ Liq F_ Landslide rN/A Floor Suite No
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Description of Work dtArr'�
rr. Use F GIlt tType R
4401 Lf # Stories #Units (if Res)¢
New/Add SFF� �Valuation ��arage/New/AddF Material/Labor 2 ?_c}ir
OWNER'SNAMEICA ��✓���
Owner's Address
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City I R- State I0 r'
APPLICANT'S NAME Last 7_11P-VA>�
Applicant's Address
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City QQG�n State I "
ARCHITECT/DESIGNER'S NAME Last 72- A,,W r�
ArchitecUDesignees Address
City ,. F—
ENGINEER'S NAME Last
Engineer's Address
Owner's E-mail Address
Zip jz6/_% Telephone
First �_JAy
Applicant's E-mail Address
ZIP %2� z Telephone /j�;/
First I /��j Lic. No.
Architect/Designees E-mail Address /
Telephone!
First
Engineer's E-mail Address
Lic. No.F--
City I State F_ Zip f Telephone F�
CONTRACTOR'S NAME/COMPANY
Lic No. r— Class
Contractor's Address
Contractor's E-mail Address
City I State F—ZiP �— TelephoneF�
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $