HomeMy WebLinkAboutXR2024-1084 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar3erm2ft Application o EV FO`
Comm]Residential City of Newport Beach - Building Division Q`
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL '���
F-Building F_ Grading F-Drainage r Elec r Mech r Plum Cu Yd Cut Cu Yd Fill F
Project Address (Not mailing address) r Flood r Fire f Liq I-" Landslide F_N/A Floor Suite Nc
,Description of Work Use F ConstTyp
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# Stories nits (i esf
Valuation $
New/Add SFF Remodel SFF Garage/New/Add F Material/Labor
OWNER'S NAME Last �U �� �( <_ [Y'j First W rZy/P.T ( C-g e - n "
Owner's Address Owner's E-mail Address
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City ��� �&s State Zip � 93 Telephone
APPLICANT'S NAME Last '1 J 1� S First 6 �dA r�
Applicant's Address- Applicant'sI E-mail Address
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Cityjf�ytr�L State � Zip ��� Telephone`s I -� �z- �O C'/
ARCH ITECT'/DESIGNER'S NAME Last First �— Lic. No. F_
Architect/Designer's Address Architect/Designer's E-mail Address
City I State �— Zip I — Telephoned
ENGINEER'S NAME Last First paEP--r0 Lic.No.�_
Engineer's Address Engineer's E-mail Address
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City �yt p State C Zip C� Telephone c�,��. 1 �cf -I 1-f
CONTRACTOR'SNAME/COMPANY 11�"4j &06-1 141�(� ILL- Lic. No. cl l�&t-A-CIass�
Contractor's Address Contractor's E-mail Address
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City �� �� State 7r ZipFj'Zg65 Telephone U f 4PZZ-43 01
SETBACKS REAR SETBACKS FRONT PERMIT NO. X zW?A - `q"
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $