HomeMy WebLinkAboutXR2025-0298 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
j- Comm'I r- Residential City of Newport Beach -Building Division j(=
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL °<-
r`Building F_ Grading
r-Drainage f-Elec rMech r Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood f- Fire r Liq r- Landslide rN/A Floor Suite No
Description of Work
Use F—ConstType F
# Storiesr # Units (if Res)F
Valuation$
New/AddSF
Remodel SF Garage/New/Add—
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Material/Labor �
OWNER'S NAME
Last First
Owner's Address
Owners E-mail Address
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City �--
`., State � i— Zip F7- — TelephoneF—1 '
APPLICANT'S NAME
Last First
Applicant's Address
Applicant's E-mail Address
city
.� State r . =i Zip-+, Telephone F77 L y✓ -
ARCHITECT/DESIGNER'S NAME Last First �— Lic. No. F—
Architect/Designer's Address
Architect/Designer's E-mail Address
City I
State 7- Zip F— Telephoned—
ENGINEER'SNAME
Last ( Lvrn First— LicNo.F—
Engineer's Address
Engineer's E-mail Address
City
State F__ Zip F Telephoned
CONTRACTOR'S NAME/COMPANY ; 1 _ { cuciuc', j 3 Lic. No. 66 zf.Qt�ClassFT
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Contractor's Address
Contractor's E-mail Address
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City 7)hl_anc�
State...... c� A Zip g1040 Telephone 3Z3 Z5(g -..5482
SETBACKS REAR
SETBACKS FRONT PERMIT NO.�7j Wvs -O
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $