HomeMy WebLinkAboutXR2025-0206 - Permit ApplicationI_Print Form Worksheet for Combo Building & Solar Permit Application o4��`°Re
r Comm'I (Residential City of Newport Beach -Building Division q
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building I— Grading F-Drainage E'lec rMech
r Plum Cu vd Cut F_Cu Yd Fill l
Project Address (Not mailing address) F_ Flood
F_ Fire F Liq r Landslide FN/A Floor No
1 to F�lorro B l�r.
Suite
� I
Description of Work YC PICC C
Llw,t%, J nIA3
Use F >E,_ronstType
Ib3,#1o4, #1v5 i {tID(o �� u ` �
o li��e
I
#Stories #Units(ifResf
'TctCe , '* jfID2,#l0( +1�202 are (E)in,
uuit 4deks bete
Valuation
New/Add SFr-- Remodel SFr— Garage/New/Addy—
$
Material/Labor 9825
OWNER'S NAME Last So(0h " First �ax uv`e
Owners Address
Owner's E-mail Address
Ile (10(Vp Ea,�lr
iv �uPPtn22lo @ cto( .cevh
City � State FCC}
Zip F92125 Telephone qLl-I)Z-.8-39ot7
APPLICANT'S NAME Last F CL+i of" First 1 -1 k j
Applicant's Address
Applicant's E-mail Address
C,So P P7, i4tr2.
I ebq}iof�e9rncciI,CDm
City �;�4, State I �K-{
Zip q; p 3 Telephone 5(e2)(o_1 CI - 517
ARCHITECT/DESIGNER'S NAME Last
First �—
Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City State F—
Zip Telephone
ENGINEER'S NAME Last
First F Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City State F
Zip F Telephone
CONTRACTOR'SNAME/COMPANY �2hewccQ Lic. No. F9gp(41 fo Class FgCl-i
Contractors Address
Contractor's E-mail Address
2z�192 tYlc,,Oc e ph
City (oQ a if (iS State I �T
Zip �2�53 Telephone 1iy)2S`i-5(20
SETBACKS REAR SETBACKS FRONT
PERMIT NO. �R a,()
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $