HomeMy WebLinkAboutXR2025-1980 - Permit ApplicationPrint Form IWorksheet for Combo Building & Solar Permit Application
omm'I residential City of Newport Beach - B I'I
wilding
NOTE: PLAN CHECK FEES DUE ATsion
TIME OF ng (SUBMITTAL
I Grading f Drainage f—Elec
Address (Not mailing
of Work ecl A j ,sr1,e
d✓ r /hL
f— Mech r Plum Cu Yd cutF—
Cu Yd Fill
j— Flood r" Fire f— Liq j-" Landslide
If'G e /�,_ E8
0
Ili9J07� �%fZ1e /Uc
New/AddSFF— F
Garage/New/Add F —
OWNER'S NAME /C4C LastF/77/ Ti
Owner's Address Ly 1 f,A^ 1/�{i�
/ 3 Owner's E-mail Address
city ?l Vre5, "S �
v/ /!/� State Y LO i7 r
Zip �2 %7 Telephoners
q Z�
APPLICANT'S NAME-----�' /
Last
1--(✓l,q XFirst
Applicant's Address t
/ Applicant's E-mail Address
t%t7yxd
city / per f'�0 A State _'� — _ �—�rUfJ — ------
iq Telephone ���---��—d—�,
ARCHITECT/DESIGNER'S NAME tJ45,5
Last ���i ✓7/ o�f� /
_ First ��A1v i.' Architect/Designer'sAddress / Lic No
Architect Designer's E-mail Address
City
State �—
Telephone
ENGINEER'S NAME
Last
First— Lic. No.�—
Engineer's Address
Engineer's E-mail Address
City
State �-- Zip
Telephone
CONTRACTOR'S NAME/COMPANY
Lic. No. 7�73_
Contractor's AddressContractor's E-mail Address
City
F— ZipTelephone
SETBACKS REAR — SETBACKS FRONT
SETBACKS LEFT PERMIT NO.
SETBACKS RIGHT t a
USE ZONE � PLAN CHECK NO.
DEVELOPMENT NO PLAN CHECK FEES $
rN/A Floor Suite No
Use Y_ L� Const Type v_
# Stories[ # Units (if Res)��
Valuation $
Material/Labor q� a