HomeMy WebLinkAboutXR2025-2095 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application C-Ni
rbcomm'I �idential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rtauilding rGrading rDrainage j-Elec f-Mech r-Plum cuYdCut F CuvdFill F
Project Address (Not mailing address) Flood j- Fire I- Liq r Landslide rN/A Floor Suite No
Description of Work A %%�G F�Iz G4'T ✓L �� ' �t,2 7 �l Z'
UsevConstType F-T3
# Stories . # Units (if Res)
%'�/-% T,o�=,fir-0�r��,C'�� �v� ��i�Y
Valuation $ ••
New/Add SFF_ Se ��Lj! 4%r� Garage/New/Add F—
Material/Labor / / 2 7S
OWNER'S NAMEfig! First /� y L LL7 �/
/ 77 41ti,, tF
Owner's Address Owner's E-mail Address
%3/ 7s-/ t,ny ztv � �, ,/Vtl;�01kiy,co
City ! /L% State Fr,4 ZiP aj7� / 7 Telephone%— 77a
APPLICANT'S NAME Last �� ti /Q x First i
Applicant's Address Applicant's E-mail Address
/,
city State Zip Tele honey may•— ?�, "-5 �fl�/
r( r p /��K Z p Ci
ARCHITECT/DESIGNER'S NAME Last A/, First •?'
/a < Lic. No 7g •Z?�
Architect/Designer's Addresses Architect/Designer's E-mail Address
Pie k1
City State p Telephone
ENGINEER'S NAME Last First F Lic. No.1—
Engineer's Address Engineer's E-mail Address
City State F Zip F Telephonel—
CONTRACTOR'S NAME/COMPANY Lic. No. F Class
Contractor's Address Contractor's E-mail Address
City State F— Zip F Telephoned
SETBACKS REAR SETBACKS FRONT PERMIT NO. Y RZ(jZ�
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $