HomeMy WebLinkAboutXC2024-0295 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
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City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building Grading
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Project Address (Not mailing address) I- Flood j- Fire r Liq r Landslide RN/A Floor Suite No
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Description of Work
Use Fi— ConstType 5 8
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New/Add SF�
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Material/Labor
OWNER'S NAME
Last CI(flk First FSAAA44
Owner's Address
Owner's E-mail Address
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APPLICANT'S NAME
Last ►�►Ru��iy _ - - _ - First 6012.
Applicant's Address
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APICH 1 00r C-4V I5 Applicant's E-mail Address
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City
State CI r} Zip 1029i Telephone 9r�C�33
ARCHITECT/DESIGNER'S NAME Gr —
Last 1L First GOJa Lic. No. I ?�
Architect/Designer's Address
Architect/Designer's E-mail Address
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City
State �,� Zip 9pyg� Telephone 9c` ��O
ENGINE
Last First— Lic. No.
Engineer's Address
Engine i Address
City
State Zip F Telephone
CONTRACTOR'S NAME/COMPANY ALg¢OTv'S f0"jJCS Lic. No. tyms2i-)3Class�
Contractor's Address
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ontractor's E-mail Address
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State Cq_ Zip 92SO/ Telephone F719 -120 _71
SETBACKS REAR
SETBACKS FRONT PERMIT NO. A (r J
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK N04?CjffjWTW
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $