HomeMy WebLinkAboutXR2024-0549 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
"itomm'I esidential City of Newport Beach -Building Division t ) NOTE: PLAN r;HFrK FFF.c ni IF: AT rinnG nc ci ionnrr-rni ..
uilding r Grading rDrainage r Elec r Mech r Plum CuYdCut [_ CuvdFill F_
Project Address (Not mailing address) F Flood r Fire r Liq Landslide i—N/A Floor Suite No
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Description of Work 41�41 --A— Z>14"AAA'
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# Stories # Units (if Res)[7
Valuation $�
Material/Labor
New/Add SFr---
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Garage/New/Add
OWNER'S NAME
Owners Address �C
Owner's E-mail Address
City / State
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ZIP Telephone J�-7�r ..
APPLICANTS NAME Last (/fix
First
Applicant's Address
Applicant's E-mail Addre s
Z D j /Z /Q
City !�%�fi�iQ� /JLAJ(/v7 State
Zip �G7{OIPZ- Telephone S,f `v�ri[) —GAS
ARCHITECT/DESIGNER'S NAME Last V_Al L i��� �
Architect/Designer's Address
First �`/ LicN
Architect/Designer's E-maifAAddress
City State �_
Zip TelephoneF—
ENGINEER'S NAME Last F—
First F— Lic No.r`—
Engineer's Address
Engineer's E-mail Address
City F State I
Zip F— TelephoneF_
CONTRACTOR'S NAME/COMPANY
Lic No. [_----- ClassF—
Contractor's Address
Contractor's E-mail Address _7c 7
City r— State F—
Zip F— Telephoned
SETBACKS REAR SETBACKS FRONT
PERMIT NO. X K �— 0 5_ -/ C�
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.?CZ.OZy — (J y
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $