HomeMy WebLinkAboutXR2025-0620 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F Cori N"Residential City of Newport Beach - Building Division
NOTE: PLAN CHFCK FFFR r11 IF AT TMAn nc Di iDft A! rAi
,Building Ty Grading
)-"Drainage j- Elec j Mech ( Plum CuYdCut s CuvdFill
Project Address (Not mailing address) T` Flood r Fire j" Liq j'-" Landslide rN/A FloorSuite No
Ilo—•�
(-'i �4`4rr �1 I�r: $ tom. FT_
Description of Work
Use JK 1/Const Type
I
# Stories # Units (if Res)F—
Valuation $
) � �S ' 4. C
Material/Labor /
New/Add SF
•�
Remodel SF I; 2 j (- Garage/New/Add F_
OWNER'S NAME
Last i__
First �,•y,4� (. ce��,+..�j
Owner's Address
Owners E-mail Address
5�� IJcvj�ar-t
City �Qv�1nt- 7�w�tn
State rA Zip 7170c,- Telephone
APPLICANT'S NAME
Last First
Applicant's Address
Applicant's E-mail Address
City F�-
State �� Zip Telephone[-
ARCHITECT/DESIGNER'S NAME Last ^�
�i�'ai«,1+.-c. First '���<•. ,., Lic No. QF'i)
Architect/Designer's Address
Architect/Designer's E-mail Address
City C: ,.4- "trr-.
State : Zip j 7_ r l- Telephone '7rh Y
ENGINEER'S NAME
Last First F_ Lic. Nose
Engineers Address
Engineer's E-mail Address
City
State F_ Zip F_ Telephonef�
CONTRACTOR'S NAME/COMPANY, ' Lic No.7'---11 Class 1i
Contractor's Address
Contractor's E-mail Address
City
State C. Zip 7 Z C- 47 Telephone 7r -r
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES S