HomeMy WebLinkAboutXR2025-1738 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
r Comm] eResidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Building F_ Grading F-Drainage F_ Elec r Mech Plum Cu yd Cut Cu vd Fill
Project Address (Not mailing address) i— Flood f— Fire F_ Liq (-- Landslide F_N/A Floor Suite No
Description of Work
Use Const Type F
# StoriesT #Units (if Res)
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Valuation $
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New/Add SF N Remodel SF F-_—_— Garage/New/Add �Material/Labor
OWNER'S NAME Last v/Jv First I 7fZ,AC-,J
Owner's Address Owner's E-mail Address
City l ivy-�N'�`�(1'n .��ry�,Gy� State �_ Zip Z4� TelephoneF—
APPIICANT'S NAME Last Z ` I�I.+CL� First /v
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Applicant's AddressApplicant's E-mail Address
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._ Zip cj-5,Z6 Telephone Ci 1--7
City bA1A State I
ARCHITECT/DESIGNER'S NAME Last A First �_ Lic. No. F_
Architect/Designer's Address Arch itect/Designer's E-mail Address
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City I C," 1"1,-S-A State I- � - Zip I TelephoneF _
ENGINEER'S NAME Last FirstF—Lic. No.( --
Engineer's Address Engineer's E-mail Address
City r-_-� State Zip F- TelephoneF��
CONTRACTOR'S NAME/COMPANY I N � J Lic. No. 62Z3Lo � Class `
Contractor's Address Contractor's E-mail Address
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City 1 1=, �j��•t (3�j.V)y} State I r-A� Zip Telephone Ot. k1=1----;Iq �Lo
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES S