HomeMy WebLinkAboutXR2025-1982 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
j- Comm'I r Residential City of Newport Beach - Building Division q
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL a
j`Building r Grading f-Drainage (-Elec rMech
r Plum Cu Yd Cutl Cu Yd Fill
Project Address (Not mailing address) r Flood
Fire j- Liq Landslide Fi Floor Suite No
Description of Work
Use ConstTypeF
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# Stories #Units (if Res)
Valuation $
Material/Cabo /�G (
`� " ' %-
New/Add SF�-- Remodel s 1Z v 1 7Z Garage/NewlAdd �
OWNER'S NAME Last (.LLLUvI ti t\'
First 7��-�✓/h%
Owner's Address
Owner's E-mail Address
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City ^ t l 1L �i 1 I,T `�C i� State G
Zip r C� z (( 4: �' Telephone /7 Lf �/ 'C</
APPLICANT'S NAME Lastr,(LLlyLf4vti'
First,}�L/ rti;
Applicant's Address
Applicant's E-mail Address
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City f ci t�r�C State
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Zip / Telephone
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ARCHITECT/DESIGNER'S NAME Last
First _— — F_f
Lic. No.
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
r—_ State F_
Zip F—.---- Telephoned-----
ICity
ENGINEER'S NAME Last (—u.-----
First F_ Lic. No.F—
Engineer's Address
Engineer's E-mail Address
(City
State --
Zip F TelephoneF—
CONTRACTOR'S NAME/COMPANY
Lic No. r-- Class
Contractor's Address
Contractor's E-mail Address
City ��-- State f __
Zip F_ TelephoneF—
XP02-5
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SETBACKS REAR SETBACKS FRONT
PERMIT NO. ,S . 1 t —1 O
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES S