HomeMy WebLinkAboutU2024-5302 - Permit ApplicationPrint Form_ Worksheet for Combo Building & Solar Permit Application oF'Eo-'�M'm
j- Comm] F_ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) F_ Flood r Fire i- Liq r Landslide FN/A Floor Suite No
Description of Work
Use Const Type
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# Stories #Units (if Res)
M, 23
Valuation $
New/Add SFF__ Remodel SF F_Garage/New/Add F_
Material/Labor v [�
OWNER'SNAME Lash 7C �{ --�f First I rA,f
Owner's Address Owner's E-mail Address
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City ; , � j . A State ` f�, Zip F Telephone 6O E - g kq - `[
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
City State Zip Telephone
ARCHITECT/DESIGNER'S NAME Last First F—
Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State F_ Zip F__ Telephoned
ENGINEER'S NAME Last Z.� b t r First �— Lic. Nofi
Engineer's Address Engineer's E-mail Address
City State F___ Zip F__ Telephoned
CONTRACTOR'S NAME/COMPANY ` Lic No. p 133 Class Li
Iff
Contractor's Address Contractor's E-mail Address
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City J Pr rn � ,+ State c A ZiP c1 "- Telephone i',_y `l % g - 0 i
SETBACKS FRONT NO.
SETBACKS REAR PERMIT
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SETBACKSLEFT SETBACKS RIGHT PLAN CHECK
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $