HomeMy WebLinkAboutXR2025-0929 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F Commit ( Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) f Flood F Fire F Liq F Landslide rN/A Floor Suite No
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OWNER'S NAME Last �Y u
Owner's Address
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APPLICANT'S NAME Last ALSq V_ V el
Applicant's Address
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ARCHITECT/DESIGNER'S NAME
Last
Architect/Designer's Address
First
Owner's E-mail Address
Use F—ConstType F—
# StoriesF_ # Units (if Res)_
Valuation $
Material/Labor /coo
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Applicant's E-mail Address
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ZIP ! Z-Q8D Telephone -(14 %9 513 8
First F� Lic. No. F�
Architect/Designer's E-mail Address
City State F_
zip F—
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ENGINEER'S NAME Last
First F� Lic Nof�
Engineer's Address Engineer's E-mail Address
City I State
ZiP J� TelephoneF�
CONTRACTOR'S NAME/COMPANY
Lic. No. F_ Class
Contractors Address Contractor's E-mail Address
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City
State �� Zip F— TelephoneF�
SETBACKS REAR SETBACKS FRONT PERMITNO, _ gUJ57 - o9t�
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES S