HomeMy WebLinkAboutU2025-0193 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division o�
r Comm'I [Residential ninrc• Di ANI CHECK FEES 111 IF AT TIME OF SUBMITTAL
'wilding r Grading rDrainage F, Elec r Mech r Plum CuvdcutF�7 Cu Yd Fill F
Project Address (Not mailing address) r Flood r Fire r Liq r, Landslide rN/A Floor Suite No
Description of Work
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# Stories #Units (if Res)
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Valuation $
Material/Labor
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New/Add SFF Remodel SF Garage/New/Add
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OWNER'S NAME Last vU T UYl1RV� First
Owner's Address Owner's E-mail Address
City N IZ? State GA Zip Telephone 8 I b
APPLICANT'S NAME Lasts �� First 1.?0
Applicant's Address Applicant's Address
Email
City I 4whe erl rk,— State F_ Zip "'j?V,j Telephone .5-1 1 0 - F466
ARCHITECT/DESIGNER'S NAME Last 6� r First Lic. No. /- r %� - °/' 7
Architect/Designer's Address ArchitecUDesigner's E-mail Address
City State F_ Zip Telephoned
ENGINEER'S NAME Lash r,� `� n First j t 1-4 -re- ft Lic. No. 6 (. �2
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Engineer's Address Engineer's E-mail Address
Gl® tA rj^F I'n v�o. �8n in 1 i� callfaYQrna pnr�,rlGnr In�co.er�►h
City Tv� n . c ... Staterk— Zip q ��� Q Telephone G�
CONTRACTOR'S NAME/COMPANY Lic. No. F ClassF
Contractor's Address Contractor's E-mail Address
City State F Zip I Telephoned
SETBACKS REAR SETBACKS FRONT PERMIT NO. t Z6-S 61 Q 3
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $