HomeMy WebLinkAboutXR2025-0909 - Permit ApplicationPrin[ Farm Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division
Comm] �( Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
%Building rW Grading (--Drainage I`-Elec r'"Mech (-'-Plum CuYdCut I CuYdFill
jest Address (Not mailing address) (- Flood r- Fire I— Liq i" Landslide r_N/A Floor Suite No
7 2 2- 1 -/- I---_
New/Add SF F- � Remodel SF 1 2 SF Garage/New/Add F_
Use R Const Type -y%' )j
# Stories[— # Units (if Res)F
Valuation $ Material/Labor 5 2? q: 5_ 0
OWNER'S NAME Last l First /(V)Or- 6C.v Pekin � ttl,vrh1-;
Owner's Address Owners E-mail Address
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City fdt,rperr &c4t1n State F CA _ ZipFL, v TelephoneF
APPLICANT'S NAME Last I First
Applicant's Address Applicant's E-mail Address
City State F__ Zip F_ Telephone
ARCHITECT/DESIGNER'S NAME Last First (LyavY, Lic. No. I C'HCt�'I
Architect/Designer's Address Archii�tecUDDeesigner's E-mail Address
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City 1 �Cys State Ck Zip QLi�L�- Telephone �fl-t �t+Cj-76.I;p
ENGINEER'S NAME Last I First F _- Lic. No.1
Engineer's Address Engineer's E-mail Address
City 7� State �W Zip Telephone[ —
CONTRACTOR'S NAME/COMPANY Lic. No. )bF2 Zi S Class )k/
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Contractor's Address
Contractor's E-mail Address
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City
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- State I ff,
Zip °IL(,) ]-
Telephone 71 q7-e-s C
SETBACKS REAR
SETBACKS FRONT
PERMIT NO. /\V-2
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES S