HomeMy WebLinkAboutXC2025-5076 - Permit ApplicationOr
Print Form Worksheet for Combo Building & Solar Permit Application o4�`'°°ge
Newport City of Beach - Building Division o:^
%Comm'I (— Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
r4uilding T` Grading f—Drainage rElec rMech
Plum CuYdCut F CuYdFill
Project Address (Not mailing address) I- Flood
T` Fire T Liq T" Landslide ("N/A�—Fl0000r Suite No
I 4- 0
` 22,, AA.C" tl", [')GVQ
13,6 jC G.
Description of Work
Use Const Type F4
121/7. Y V" � I I l, J6'L.
S v L, n
It StoriesFt # Units (if Res)
��/z
F— 7-yJ �-----
New/Add SF Remodel SF Gara
g �.-....---
e/New/Add
Valuation $ O
Material/Labor �.,
OWNER'S NAME Last k1 j e INS y
First rn �Y
Owner's Address
Owner's E-mail Address
LPr' 01-Y t AF4',FTTr AV,�/vve
City Nee-. _y. State CA
ZiPF Telephone ELI ? '- --
APPLICANT'S NAME Last 'V;V'DVpr,
Firstl`r. �
Applicant's Address
Applicant's E-mail Address
I
City State
Zip Telephone ��N �� `7 y
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City State
Zip I � TelephoneF_
ENGINEER'S NAME Last � �
First Lic. No.1
Engineer's Address
Engineer's E-mail Address
r-
City State
Zip �� Telephone
CONTRACTOR'S NAME/COMPANY r }
Lk. No. l i� Class
Contractor's Address
Contractor's E-mail Address
�C'1v �l✓��/t1 �1✓ <>I"
I
) nrJi�-'!/Vn /�1W_., �-r;M :cam:'+-1
City (f"7 {-fit �t�l e� F'� State � /C //
Zip '7 i - Telephone (/ l r'i
I U D !v �
SETBACKS REAR SETBACKS FRONT
PERMIT NO. X%Z dZS^SO 1 i�
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK No.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES S