HomeMy WebLinkAboutXR2025-1832 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division
jt/Comm'I "esidential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
"uilding rGrading F-Drainage I-Elec f-Mech F_Plum Cu vd Cut Cu Yd Fill
Project Address (Not mailing address) r Flood r- Fire r Liq r Landslide i-N/A Floor Suite No
Description of Work /�1 Gl Y-G�i .r7 </`� ! N / ` ��/ / �N Use �/CGonstType j�_p
/2-�G(k G'L" j� C � t # Stories # Units (if Res)
l ,/Z_ fD .. o, �r 1�l/a cZ -S /� n'r� �'�i �- in �, c, _ //vS u c. _ Fs 1-ice
/ �cT Valuation$ / nC
New/Add SF�— �Fiad€fSF � Garage/New/Add �— Material/Labor
OWNER'SNAMEtICAC. last /%ZGrN%r L U'n�AA.y Eirst �Jl!j129ee;A,
Owner's Address owners E-mail Address n
r 00"1
City 2 L %w State Zip y 2-�j j'7 Telephone G, r T2e �n
APPLICANT'S NAME
f �zo A
applicant's Address
,it„ /77 n, State I \ W—
First I CJ/-t Y
Applicant's E-mail Address
Li f� pG Co w
�j
Zip Z��Z- Telephone / lf� r r�i6
ARCHITECT/DESIGNER'S NAME Last j�h7l - i jL / First /t1 -Yl/D y Lic. N
Architect/Designer's Address
Citv State �—
ENGINEER'S NAME
Architect/Designer's E-mail Address
TelephoneF—
Engineer's Address Engineer's E-mail Address
Ciiv
State F— ZIP F� TelephoneF—
j
CONTRACTOR'S NAME/COMPANY !(� I ;o •,Lic No. I CVC 1-Y3 Classl
tractor's Address t Contractors E-mail Address
1R
State F— Zip �— TelephoneF�
SETBACKS FRONT
SETBACKS RIGHT
PERMIT No. X UOU - t C& 3 2
PLAN CHECK NO.
DEVELOPMENT NO
PLAN CHECK FEES $