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HomeMy WebLinkAboutX2021-1406 - Permit ApplicationPrint Form ; :a Worksheet for Combo Building & Solar Permit Application ,�� ° X Comm'I n Residential City of Newport Beach - Building Division 2�- � V v NOTE: PLAN CHECK FEES DUE AT TIME OF SUBM AL<,.oa" Building ❑Grading Drainage ❑Elec f- �iPlum CuYdCut cuvdFill �! FI Project Address (Not mailing address)i Flood (—I Fire ❑ Liq Fj Landslide ❑N/A Floor Suite No 3323 Pacific View Dr (CS) cell site Description of Work Use FJ Const Type erizon proposed modifications to existing wireless installation, # Stories7l#Units (if Res) Valuation $ [307,000 Material/Labor New/Add SFRemodel Garage/New/Add �� OWNER'S NAME Last Rector First ardens & Vestrymen of St. Michael -----.............. - --- ---i --- -- —— — — — Owner's Address Owner's E-mail Address 3222 Pacific Hwy --- -- --------------------------------------- City Corona Del Mar State CA """'— Zip 92625 Telephone 949-644-0463x1 APPLICANT'S NAME Last MARTINEZ - — - First LUIS Applicant's Address Applicant's E-mail Address 2347 LA PALMA AVE STE 107 _ LUIS@TANGENT.SYSTEMS.COM City KRMLINDA — - State CA Zip 92887 Tele hone562-631-7008 ARCHITECT/DESIGNER'S NAME Last First ------ -- Lic. No. 77 Architect/Designer's Address Architect/Designer's E-mail Address i City — - - - State Zip �J Telephoned ENGINEER'S NAME Last Leeper First Michael Lic. No. C-83930 J Engineer's Address Engineer's E-mail Address 506 SECOND AVE #1533 J _ City Battle State FA Zip 998104 — Telephone 42-2374749 l CONTRACTOR'S NAME/COMPANY ! Lic. No. ! Class Contractor's Address Contractor's E-mail Address City - State �! Zip Telephone SETBACKS REAR SETBACKS FRONT PERMIT NO. )(Zosl " 1-` D6 SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 12.31 - ZO Z 1 USE ZONE DEVELOPMENT NO PLAN CHECK FEES $