HomeMy WebLinkAboutXR2022-2155 - Permit ApplicationPrint Form
f— Comm'I r, Residential
Worksheet for Building Combo Permit Application
City of Newport Beach - Building Division o a
NOTE: PLAN CHECK FEE DUE AT TIME OF SUBMITTAL
jK';Building [,Grading Drainage F_Elec Mach
rPlum CuvdCut CuYdFill s
III
Project Address (Not mailing address)
Floor Suite No
319 Narcissus Ave. Corona Del Mar, CA 92625 F__:
Description of Work
Use F
ine wall addition
# Stories # Units (if Res)r1
New/Add SFF Remodel SF�— Garage/New/Add r
Valuation $ c G
Material/Labor L J
OWNER'S NAME Last Rapp
First Michael
Owner's Address
Owner's E-mail Address
319 Narcissus Ave.
Michael.rapp26@gmaiLcom
City Corona Del Mar State CA
Zip 92625 Telephone 9496337950
APPLICANT'S NAME Last Rapp First Michael
Applicant's Address
Applicant's E-mail Address
319 Narcissus Ave.
Michael.rapp26@gmaiLcom
City rCorona Del Mar State CA
Zip 92625 Telephone 9496337450
ARCHITECT/DESIGNER'S NAME Last (Goetz First ndrew Lic. No. 18499
Architect/Designer's Address
Architect/Designer's E-mail Address
2855 E Coast Highway Ste 234
goetzarch@earthlink.com
City Corona Del Mar State CA
Zip 92625 Telephone 9496733152
ENGINEER'S NAME Last Goetz
First Fndrew Lic. No 18499
Engineer's Address
Engineer's E-mail Address
2855 E Coast Highway Ste 234
goetzarch@earthlink.com
City Corona Del Mar State CA
Zip 92625 - Telephone 9496733152
CONTRACTOR'S NAME/COMPANY
Lic. No. F_ Class F_
Contractor's Address
Contractors E-mail Address
City _ _._ State F_',
Zip [-- Telephone
ENERGY P/C FEE $ FIRE P/C FEE $
ee
PERMIT NO.r}ZnCI ZZ ZI SS
GRADING P/C FEE $ PLANNING P/C FEE $
PLAN CHECK NO. PC 207- q
2- I t9 -S
ELEC/PLUM/MECH P/C FEE $
PLAN CHECK FEE $
DEVELOPMENT #
TOTAL FEES PAID $