HomeMy WebLinkAboutXR2024-0132 - Permit Application_ Print Form Worksheet for Combo Building & Solar Permit Application UFf?
F Comm'I residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OPRI IRRAITTAI
(Building r Grading
r—Drainage Elec (—Meth Plum I—
Cu Yd Cut Cu Yd Fill r
Project Address (Not mailing address) r Flood r— Fire j— Liq r— Landslide rN/Ar Floor Suite No
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Description of Work
Use ConstType�
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/i /c' �1/nJ/ll "' ll,t, f`
# Stories # Units (if Res)-
Valuatio�$
Material/rbor
New/Add SF�
Remodel SF�— Garage/New/Add �—
OWNER'S NAME
Last i First��
Owner's Address
Owner's E-mail Address
City i
State Te '+ Zip �— TelephoneF
APPLICANT'S NAME
Last First P / First
Applicant's Address
Applicant's E-mail Address
City F 1FrCt State I ` (" Zip G�UW/ Telephone Cr'�80 7606
ARCHITECT/DESIGNER'SNAME Last First F Lic. No. —
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
City I
State F_ Zip F_ TelephoneF_
ENGINEER'S NAME
Last First F— Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City
State F Zip F_ TelephoneF_
CONTRACTOR'S NAME/COMPANY
Lic. No. lG 5 L, - Class
�7W Gf r o/r'rl- /0iwe T SFir
Contractors Addresss�
z
Contractor's E-mail Address
City !
G
/ i it lcclnel 61/ lt`�A l_ C41
State Zip z C 1 G Telephone CM
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SETBACKS REAR
SETBACKS FRONT PERMITNO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK 40.
V 1—
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $