HomeMy WebLinkAboutXR2024-0365 - Permit ApplicationPrint Form Work§heet for Combo Building & Solar Permit Application s"e
Fv/Comm'I Ft4esidential 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 F_ Fire r Liq r Landslide F_N/A Floor Suite No
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Description of Work zVA x4/42:�f /21_s 1_-X
Use/F�6/ Const Type -A
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OWNER'S NAME Last First
Owner's Address Owner's E-mail
City -State Zip Telephone[--
APPLICANT'S NAME Last 7,P—UAX First
Applicant's Address Applicant's E-mail Address
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City 15L4/OD State Zip �Z6�pZ Telephone G/—Z�Lj—�jlj�/�
ARCHITECT/DESIGNER'S NAME Last i l j�j �u � First �ANO,/ Lich
Architect/Designer's Address Architect/Designer's E-mail Address
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City � Zip Telephone--_
ENGINEER'S NAME Last First �— Lic. No.�
Engineer's Address Engineer's E-mail Address
City State F Zip Telephonef —
CONTRACTOR'S NAME/COMPANY Lic. No. F Class
Contractor's Address Contractor's E-mail Address
City I State F_ Zip F Telephoner.
SETBACKS REAR SETBACKS FRONT PERMIT NO. l �0367
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. Z87."O S
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $