HomeMy WebLinkAboutXR2025-0537 - Permit ApplicationPrint Form 6 Q
Worksheet for Combo Building &Solar Permit Applicatio Comm'I (" Residential City of Newport Beach - Building DivisionNOTE: PLAN CHECK FEES DUE AT TIME OFSUBMITTAI
Tr,Building Grading r"Drainage (`XElec r Mech
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r- Plum cuYdCut F CuYdFill F
Project Address (Not mailing address) r- Flood r" Fire r" Liq r- Landslide r_N/A Floor Suite No
40 Y/
Description of Work
Use t.<5 ConstType
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N StoriesF # Units (if Res)
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Valuation $ -
Material/Labor ,.n� b` L'UL` •�
New/Add SF o` Remodel SFr v Garage/New/Add
OWNER'S NAME Lasty�
First 71 V-)
Owner's Address
Owner's E-mail Address
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City j'_. Q
d � � .} rjL,L t� State F ,�
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Zip y Z CL, � Telephone 7/t_1
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APPLICANT'S NAME 1
Last ` � � v_
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First G �7 F
1
Applicant's Address
Applicant's E-mail Address
77-F�
City FL-Y' state /
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Zip 6S Telephonel l 3s- LjS-� >
ARCHITECT/DESIGNER'S NAME Last �-
First L<TLicNo. F
Architect/Designer's Address
Architect/Designer's E-mail Address
F.
City �,1r� State 7�7
ni
Zip ��. ��� Telephone 3 3767
ENGINEER'S NAME Last ? 1 F r—
So1��aC „S ��� FirstF_
Engineer's Address
Engineer's E-mail Address
City �— � State
Zip F_ TelephoneF_
CONTRACTOR'S NAME/COMPANY / ` Lic. No. ClassF
Contractor's Address
Contractor's E-mail Address -7 ✓ (� l
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City �,-)c• �.`^ U� _\ State L,!
Zip /7C EC, TelephoneM---F/u
SETBACKS REAR SETBACKS FRONT
PERMIT NO. �C 22(it--� C6_,4, 7
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES S