HomeMy WebLinkAboutX2019-3578 - Permit Application (2)Pnnt Form , '� Worksheet for Combo Building & Solar Per mj$_4plication
EX City of Newport Beach - Building Division X
Comm'I ❑Residential
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[X'Building ❑Grading ❑'Drainage ❑Flet ❑Mech I jPlum Cu Yd cut Cu Yd rill
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Project Address (Not mailing address) ❑ Flood ❑ Fire r]Liq ❑Landslide ❑N/A Floor Suite No
1200 Dove StreetI
Description of Work
U
Use Const Type 36 71
# StoriesC # Units (if Res)F
' I
Valuation $
New/Add SF 202 Remodel SF Garage/New/Add Material/Labor 30,000 --
OWNER'S NAME Last Church's Inc. First The Lost Bean
Owner's Address Owner's E-mail Address
2698 Newport Blvd —_ —_ � bodierasmussen@gmail.com
City Costa Mesa _ State CA Zip 92626 Telephone
J
APPLICANT'S NAME Last
First
Applicant's Address Applicant's E-mail Address
17200 Red Hill Ave. jchoi@synarestudio.com
City Irvine StateCA Zip 92614 Telephone 949-596-7362
ARCHITECT/DESIGNER'S NAME Last Ctioi FirstJefferson _ J Lic. No. C31631_ --j
Architect/Designer's Address Architect/Designer's E-mail Address
17200 Red Hill Ave —_ jchoi@synarestudio.com j
City Irvine -- _ State CA Zip 92614 Telephone949-596-7362
Lic. No. m-2622
ENGINEER'S NAME Last Nour _ _ J Saum First 1
Engineer's Address Engineer's E-mail Address
3839 Birch Street snour58@gmail.com
City Newport Beach ! State CA Zip 1/926600 Telephone 949-852-8700
CONTRACTOR'S NAME/COMPANY n/a Lic. No. ��I! Class
Contractor's Address Contractor's E-mail Address
City State �� Zip [--i Telephone[ -77-77-71,
SETBACKS REAR
SETBACKS LEFT
SETBACKS FRONT
SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
PERMIT NO.
PLAN CHECK N6.
PLAN CHECK FEES $ �S-ZD• ���