HomeMy WebLinkAboutU2025-0700 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
r Comm'I XResidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building F_ Grading j—Drainage F_ Elec r Mech
r Plum Cu Yd Cut Cu Yd Fill F
Project Address (Not mailing
address) F_ Flood r Fire r Liq r Landslide F_N/A Floor Suite No
Description of Work
Use F—ConstType F
# Stories #Units (if Res)
Valuation $
Material/Labor O mot"-"-'
New/Add SF�— RemodelSFF— Garage/New/Add
OWNER'S NAME Last f5t
0VA2int'6,,D
First
Owner's Address
Owner's E-mail Address
6O 1
'P'--
City /U CAW �e7�i� �'
0- State C �
Zip z j Telephone O Z _ 'SU
1
APPLICANT'S NAME Last
6&(A �,�.
First /
Applicant's Address
Applicant's E-mail Address
City
State
Zip— Telephone/ �•�S
ARCHITECT/DESIGNER'S NAME
Last
First �— Lic. No. �—
ArchitecUDesigner's Address
Architect/Designees E-mail Address
City
State F
Zip F — TelephoneF
ENGINEER'S NAME Last
F
First �— Lic. No.r
Engineer's Address
Engineer's E-mail Address
City
State 7—
Zip F Telephoned
CONTRACTOR'S NAME/COMPANY
y7 I/ n r) .( / Lic No 6�(�(��� CZ Class 7
rC�l 1fiL— 4Coontrraactolr's
Contractor's Addr ss
E-mail Address
��Q
/ U 2.Cr `�-
City u�1 10141 �
�
�I State l K
Zip Telephone //% S7/7
—c d
SETBACKS REAR
SETBACKS FROIIII....NT
PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $