HomeMy WebLinkAboutXR2024-5580 - Permit ApplicationPrint Form IWorksheet for Combo Building & Solar Permit Application QIGA�2
jt/'Comm'I (�sidential City of Newport Beach - Building Division
40TE: PLAN CHF(.K FFFS ni is AT Tined nr o, 1 ,....
jr-lluilding r-Grading [-Drainage j-Elec F_Meth j-Plum CuYdCut Cu Yd Pill
Project Address (Not mailing address) F_ Flood r Fire r Liq r Landslide rN/A Floor Suite No
Description of Work Llfle4- i2If
Use ConstType
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#Stol # Units (if Res)
Valuation $
Material/Labor
New/Add SF Be�Nodel SF �7G-S�' Garage/New/Add �—
OWNER'SNAMEI(�('_
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Owner's Address
Owner's E-mail Address
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City / / State I 7A Zip %Z>'/-;?' Telephone) rZ •G;9'l�
APPLICANT'S NAME Last -�/L U f4X First A y
Applicant's Address
Applicant's E-mail Address
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City A!j?,jiA ����;iv� State LJ1 Zip �L��F'L Telephone TF- ` eI -C�j I�
ARCHITECT/DESIGNER'S NAME
Last %G A V1 - I First Lic. N 7
Architect/Designer's Address Architect/Designer's E-mail Address
COY State TelephoneF�
ENGINEER'S NAME Last F— First F_Lic. No.F�
Engineer's Address Engineer's E-mail Address
City I— State �— Zip F_ Telephone
CONTRACTOR'S NAME/COMPANY Lic. NoT— Class
Contractor's Address Contractors E-mail Address
City I State �— Zip �-- Telephone --
SETBACKS REAR SETBACKS FRONT PERMIT NO. -;
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK N
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $