HomeMy WebLinkAboutXR2024-6615 - Permit ApplicationPrint Form j Worksheet for Combo Building & Solar Permit Application o4�Ew`°R>a
r'�Comm'I �sidential City of Newport Beach - Building Division p
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
FWuilding r- Grading F-Drainage r Elec r Mech F- Plum CuydCut s CuYdFill
Project Address (Not mailing address) r Flood r- Fire r• Liq F_ Landslide rN/A Floor Suite No
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Description of Work GG72'G� ���Y/.�"T/Jyt/ f Qx"} 1 tlAJ
Use �ConstType L'
# StoriesT # Units (if Res
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Valuation $
Material/Labor
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�,mo SF �,Q Garage/New/Add Ir
New/Add SF1 F2
OWNER'S NAME/ C 7� a"IPj{7vy_Firs lo'J- l DLGi/lL�k;X 17/f
Owner's Address Owner's E-mail Address
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City State - Zip JZ61 7 Telephone % '72(j - -`Ze-`7
APPLICANT'S NAME Last First ,xi/
Applicant's Address Applicant's E-mail Address
City Gl'�(J}! State Zip Telephone q�J-O'
ARCHITECT/DESIGNER'S NAME LastjFirst Lic N oy
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Architect/Designer's//Address Architect/Designer's E-mail Address
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City p Telephone�—
ENGINEER'S NAME Last FirstF Lic. No.s—
Engineer's Address Engineer's E-mail Address
City State F_— Zip F— Telephones
CONTRACTOR'S NAME/COMPANY Lic. No. F Class
Contractor's Address Contractor's E-mail Address
City State Zip TelephoneF_
SETBACKS REAR SETBACKS FRONT PERMIT NO. k�&zzr/Lq - bbIS
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $