HomeMy WebLinkAboutPV2024-0059 - Permit ApplicationPrint_Form Worksheet for Combo Building & Solar Permit Application U4
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City of Newport Beach -Building Division
r Comm'I j- Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding r Grading rDrainage
Elec r Mech r Plum Cu Yd Cut l Cu Yd Fill
Project Address (Not mailing address) Flood r Fire Liq r Landslide F-N/A Floor Suite No
/7C3--oc2�� 151� Use ConstType
Description of Work
j!✓ l� C /� c 'T L #Stories #Units (if Res)
J, 5 4 11 4 3, 5 60
121/
_ RemoValuation $
Remodel Garage/New/Add— Material/Labor C6'[)(j0
New/Add SF�-- -
SL J /�
OWNER'S NAME Last � / u ` First--
Owner's Address Owner's E-mail Address
State '4 Zi Telephone--
city ` p - - -
- ' . Last �-c- -.. _ First
APPLICANT'S NAME
Applicant's E-mail Address
Applicant's Address
State ("y Zip Telephone
City Lv,Lic. No.
,� /z 4c
ARCHITECT/DESIGNER'S NAME Last
First—
Architect/Designer's E-mail Address
Architect/Designer's Address
-
City ----------- State �— Zip �_ - TelephoneF—
_ _ — _
First-- Lic No.�—
ENGINEER'S NAME Last _ _ -
Engineer's E-mail Address
Engineers Address
. State Zip Telephone_ —..
City I -
L Lic No. U(v y y.j Class s, L o
CONTRACTOR'S NAME/COMPANY NI G� Yuy -
Contractor's E-mail Address
Contractor's Address
rU7 C�c.��fi Sd 60 Y. LO LIT— —— --
4 D d
city
State �S Zip lJY(j� Telephone
S _
SETBACKS FRONT PERMIT NO. ��llbwl • a65g
SETBACKS REAR
—�--' PLAN CHECK NO. `�G1.h9, •n4�-1
SETBACKS LEFT SETBACKS RIGHT
USE ZONE
DEVELOPMENT NOaTW PLAN CHECK FEES $ �—