HomeMy WebLinkAboutXR2025-1815 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application wRr
City of Newport Beach - Building Division o.
F_ Comm'I Residential NOTE. PLAN CHECK FEES DUE AT TIME OF SUBMITTAL f �m
,j�'Building F_ Grading (—Drainage (—Elec FMech Plum CuYdCut F CuYdFill r
Project Address (Not mailing address) 7 Flood r Fire r Liq F_ Landslide FN/A Floor Suite No
13 4�oc L1 /a,c.,
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Description of Work 5MC u t
Use FKConst Type
# StoriesF # Units (if Res)[—
Valuation / ' 0 0
Material/Labor` '
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New/AddSFr�.— Remodel SF� Garage/New/Add
OWNER'S NAME Last
First }—S 64,_
Owner's Address
Owner's E-mail Address
o. X to -j
MCm _rs proax K eg MD; I. QA m
City Wi-01� dk` ryv „,—
State �— ZipFL7 �7(�� Telephone �e�.9-�yb- Oo40
APPLICANT'S NAME Last ,o (��iFirst
Applicant's Address
Applicant's E-mail Address
City
State F_ Zip F_ Telephoner--�,�'.
ARCHITECT/DESIGNER'S NAME
Last-- First F — Lic. No. F_
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
City I
State r_ Zip F_ Telephoner�—
ENGINEER'S NAME Last I
First r_ Lit. No.r
Engineer's Address
Engineer's E-mail Address
City
State F_ Zip Telephone r_
CONTRACTOR'S NAME/COMPANY
Lic No. ^. Classr�
Contractor's Address
Contractor's E-mail Address
City
State F Zip r_ Telephone
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES S