HomeMy WebLinkAboutXR2024-6227 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
Ft,<omm I Residential City of Newport Beach - Building Division I00L7
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL .� p
tB'uilding rGrading j-Drainage rElec i-Mech i-Plum CuvdCut CuYdFill [_
Project Addss (Not mailing address) i- Flood r Fire r- Liq r Landslide Floor Suite No
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Description of Work G� %' /L ,Ya'a t `fiY'�f /�-v
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Use�fonst Type T'_ �/_,j
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if Stories _& /# Units (if Res)
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Valuation$ ter, rtp
Material/Labor UC- -
/4ST
New/AddSF� .J3emndSF `�`% c�rGarage/New/Add—
OWNER'S NAME`��(�/ <4.ast �f21 -'/� rG L C Yf��ld71-11
Owner's Address Owner's E-mail Address
117,71 y'g'�' 'y
City / t1,State ,d Zip 7�-/F' j-% Telephone -?f
APPLICANT'S NAME Last First I
Applicant's Address Applicant's E-mail Address
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City /_7;iZ7>i'/1 S� G/JState A Zip /L(v�''` Telephone �Y4, Zct;),6 _�SE/�F
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ARCHITECT/DESIGNER'S NAME Last I , Z / -,XL) fZl First c.-%W IL /1( Lic. N
Architect/Designer's Address Architect/Designer's E-mail Address
City State ip TelephoneF_
ENGINEER'S NAME Last First Lic. No.F
Engineer's Address Engineers E-mail Address
City r State F— Zip F— Telephoned
CONTRACTOR'S NAME/COMPANY Lic. No. I ClassF
Contractor's Address Contractor's E-mail Address
City State F___ Zip F_ Telephoned
SETBACKS REAR SETBACKS FRONT PERMIT NO. I!LQ22' 1
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK N .
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $