HomeMy WebLinkAboutXR2024-0185 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application 0"Vi"NF- Comm'I j— Residential City of Newport Beach - Building DivisionNOTE PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding r Grading
F-Drainage [ Elec r—,Mech
r- Plum CuYdCut F CuYdFill
Project Address (Not mailing address) I— Flood
I— Fire F_ Liq r Landslide F_N/A Floor Suite No
' escription of Work
Use F ConstType F
# StoriesF_ # Units (if Res)_
Valuation
bor UU
New/Add SFF— Remodel SFF— Garage/New/Add F__Material/Laa
OWNER'S NAME
Last
First
Owner's Address
Owner's E-mail Address
City
State F
Zip F— Telephone —
APPLICANT'S NAME
Last
First
Applicant's Address
Applicant's E-mail Address
City
State F
Zip F Telephoner
ARCHITECT/DESIGNER'S NAME Last
First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
-
State F—
Zip F_ Telephoned
ENGINEER'S NAME
Last
First Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City
State I
Zip Telephone�—
CONTRACTOR'S NAME/COMPANY �/ kGt Vvj CODS fVuG f1 Lic. No. � 5 Class
Contractor's Address
Contractor's E-mail Address
!�s10 Z.nd AVenva
lnGal9C�i /t�s� bu (C(lvs �ovy�
City Qt/ Mq,- State c4
Zip gZ6,2-s TelephoneF—
SETBACKS REAR
SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
/�
DEVELOPMENT NO I,f T - ��� PLAN CHECK FEES $