HomeMy WebLinkAboutM2025-0023 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application
Comm] r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Address
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of Work
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New/Add SF
OWNER'S NAME
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Remodel SFF Garage/New/Add i
Last �-u _Q_j-t
Suite No
Type
# StoriesF_ # Units (if Res)[ —
Valuation $
Material/Labor F
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First I
Owner's Address Owner's E-mail Address
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APPLICANT'S NAME Last I tv\:, a -1%
Applicant's Address
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City �.P��.:lDrtir'�" Ber.rl�State ��{
ARCHITECT/DESIGNER'S NAME Last
First ( --- LSa
Applicant's E-mail Address
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Zip -7, 5l Telephones 9 C. q S��S35
First
Architect/Designer's Address Architect/Designer's E-mail Address
City State F Zip F— Telephoned
Lic. No. I
ENGINEER'S NAME Last �j�-F-v'U�1 First hhe Lic. No.
Engineers Address
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City ���_ f-G�zl State I
CONTRACTOR'S NAME/COMPANY
Contractor's Address
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�.City ae.,S
SETBACKS REAR
SETBACKS FRONT
Engineer's E-mail Address
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Zip Ct'Z'� Telephone -1 N _)t
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Contractor's E-mail Address
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Zip 7�` t�- Telephone -7 "Z-Col_2�
PERMIT NO. I- 1 LU �-5 - C) C Z.3
SETBACKS LEFT
USE ZONE
SETBACKS RIGHT
DEVELOPMENT NO
PLAN CHECK NO. t?(.2f2_S_ j2.27
PLAN CHECK FEES S