HomeMy WebLinkAboutX2018-3467 - Permit Application (2)Print Form Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division X2p\� _7-;,H6%
r Comm'I r Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
�6WPpRT
B
CXBuilding (X Grading FX -Drainage fK Elec [R Mech
R Plum CuYdCutI �� I CuYdFillFill�
Suite No
Project Address (Not mailing address) F Flood r Fire C- Liq r- Landslide P(N/A( Floor Suite
4500 ROXBURY
I �—
Description of Work
Use R -3/U Const Type VB -SPK
#Stories #Units (if Res)
NEW 1 -STORY SINGLE FAMILY RESIDENCE WITH BASEMENT
_
Valuation S
New/Add SF 9,035 Remodel SF� Garage/New/Add 1,125
1 500,000
Material/Labor '
OWNER'S NAME Last Roshan
First Kasra
Owner's Address
Owner's E-mail Address
4500 ROXBURY RD
Ciry NEWPORT BEACH State CA
Zip 92625 TelephoneF—
APPLICANT'S NAME Last TEALE
First MARK
Applicant's Address
Applicant's E-mail Address
2900 BRISTOL ST., BLDG A, SUITE 203
mteale@tealearchitecture.com
City COSTA MESA State CA
Zip 92626 Telephone(949) 975-0123
ARCHITECT/DESIGNER'S NAME Last TEALE First MARK Lic. No. C-22162
Architect/Designer's Address
ArchitectlDesigner's E-mail Address
City State
Zip F Telephoned
ENGINEER'S NAME Last PATEL
First SHARAD Lic. No.#5 4488
Engineer's Address
Engineer's E-mail Address
9283 RESEARCH DRIVE
spatel@pbastructural.com
City IRVINE State CAZip
92618 Telephone (949) 943-8080
CONTRACTOR'S NAME/COMPANY
t/
`Lic. No. FS_2 9)50 Class (�
Contractor's AddressVl
Contractor's E-mail Address
tr
?AV, 1<.PJ0 0 SCE. cos
99Ga ^^
JCtJw1 ��cVv Lok 1i9
city �(� State
CAU }
Zip I Telephone q)�10_ e)q75
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. [ O
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $