HomeMy WebLinkAboutXR2025-2028 - Permit ApplicationPrint Form _ Worksheet for Combo Building & Solar Permit Application
rl/Comm'I I i rcesidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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r Cu Yd Cut—_ Cu Yd Fill
Project Address (Not mailing
Description of Work
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New/Add SFF —
(dress) r Flood j-" Fire r Liq r- Landslide rN/A Floor
Suite No
OWNER'S NAME /CigG Ease T/—aT ; f
Owner's Address
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city I //-Z V//f/P
APPLICANT'S NAME
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5f Garage/New/Add r—
Use �/,eonstType FF,4
# StoriesF j # Units (if Res)
Valuation $ GJ
Material/Labor
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Owner's E-mail Address
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StateI r-��-�T%/ _.e--.�- - - - _ - -
ZiP /2l Telephone f- 7Z0 11,�Lze
Last I / /ZiiA y
Applicant's Address{
City�G/BOA sG/1/V� State
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ARCHITECT/DESIGNER'S NAME
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Architect/Designees Address
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Applicant's E-mail Address
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Zip 921_e6 Z Telephone l-H_
First Aq ,D�e
Architect/Designer's E-mail Address
Lic. No.22c> ; I
city State
iP Telephone�—
ENGINEER'S NAME Last
First— Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City State ZIP Telephone --
CONTRACTOR'S NAME/COMPANY
Lic. No. F� Class
Contractor's Address
Contractor's E-mail Address
City - - -
State F' Zip F_ Telephonf�
SETBACKS REAR SETBACKS FRONT
� PERMIT NO. X 9,201 SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK N0,
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $