HomeMy WebLinkAboutXR2025-1412 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application
r Comm'I rVResidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[—Building F_ Grading (-'Drainage r Elec
Project Address (Not mailing
�516.
of Work
r Mech � Plum Cu Yd Cut— Cu Yd Fill
r— Flood r- Fire r— Liq r Landslide FN/A Floor
I M_., 4/-)/OG F_
151, 0) UX C \�Q tS i rho\
New/Add SFJ — Remodel SF �{ 6 Garage/New/Add
Suite No
I
Use F— ConstType
# StoriesF— # Units (if Resj-
i
Valuation 5
Material/Labor
OWNER'S NAME Last k a t A n First e
Owner's Address
Owner's E-mail Address
3 kc m P Yoh I� D w. o corn
Clty C� (oCt q CieC�r��JJjl MTV State Zip Telephone 91�2-39\0
APPLICANT'S NAME Last w6t Z J
Applicant's Address
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city Coron-A a ed mAi'- state Cor
ARCHITECT/DESIGNER'S NAME Last WQ 2
Architect/Designer's Address
51D W ks 1pur 4ve
City C,0Ya(1 t} d.el..(y, State CA
First)�hn ,\Oherfi
Applicant's E-mail Address
BUWNR rneL, l , c oZip 92Telephone 9 �( 9 _g 3 / _ 5q p-t (j
First O n tri t'r l Lic. No. ('
Architect/Designees E-mail Address
WA z .J
b 2 eJ R 60Gcna;l Co M
Zip 9T Telephone 9 yg_ g 36, 59 q Ij_
ENGINEER'S NAME Last q S i First h fLs l P� J C91 6 0 2 5
Ch C Lic. No.
Engineer's Address Engineer's E-mail Address
151 ktl) n) r
city COSt(� (`(1�5� State t=� Zip 97626 Telephone 65q
CONTRACTOR'S NAME/COMPANY Lic. No. F— ClassF_
Contractor's Address Contractor's E-mail Address
City �— State F Zip F_ TelephoneF_
SETBACKS REAR SETBACKS FRONT PERMIT NO. X� G6
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
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