HomeMy WebLinkAboutXR2025-0560 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application O�EWPoQjB
r Comm'I rXResidential City of Newport Beach -Building Division 0 4
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
,Building r Grading r--Drainage r-- Elec r- Mech
r Plum CuYci Cut F CuYdFill
Project Address (Not mailing address) r- Flood
r Fire r Liq r Landslide r_N/A Floor Suite No
Description of Work
Use 9 7uConstType Fla
G otr L.l:t cc%LvLa'l" Oci a V.,
# Stories[ It Units (if Res)
Valuation $
Material/Cabo7,6
f2d7c,
New/Add SFF_�-- Remodel SF Garage/New/Add I
OWNER'S NAME Last
First %NA-C C H .�
,Address
Owner's Address
Owner's E-mail
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City �'i,u ✓Y yLac1.. State F C,+� —
Zip `l) 6f,�t:: Telephone
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
City State F________. Zip Telephoned
ARCHITECT/DESIGNER'S NAME First��
Last I� � LicNo'
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li
Architect/Designer's Address
Architect/Designer's E-mail Address
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'yn." ��. .141� -Aa,4,lr,kcow
City I 6,l6, State Cn
Zip `I 26 j }- Telephone '7,q '2 ii -r&4c,
ENGINEER'S NAME Last I
First I� Lic. No.F
Engineer's Address
Engineer's E-mail Address
City State �.—
Zip Telephoned—.--��
CONTRACTOR'S NAME/COMPANY r['CZ LI2J
1�
Lic.No. �� Class
Contractor's Address
Contractor's E-mail Address
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City fVy��,;;,-r )%rw.k State ('A
Zij 71266L' Telephone 3l4 47f-S1c4
SETBACKS REAR SETBACKS FRONT
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PERMIT NO. ft 11 f o 0S60
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES S