HomeMy WebLinkAboutX2022-1274 - Permit ApplicationForm Worksheet for Combo Building & Solar Permit Application
Residential City of Newport Beach - Building Division
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NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[x— Building I— Grading F-Drainage r Elec F Mech F— Plum Cu Yd cut Cu Yd Fill
Project Address (Not mailing address) I— Flood j— Fire F- Liq F_ Landslide FWN/A Floor Suite No
+450 Newport Center Drive F4th 440
Description of Work T II
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rant Impf hUle'r1,dfl�ti 3f ;
New/Add SFRemodel SF 100 Garage/New/Add
OWNER'S NAME Last 'Chi ell
pp T First Ally
se onst ype -B
# Stories(6 # Units (if Res)[_
Valuation 5 D 000
Materfal/Labor I
Owner's Address Owner's E-mail Address
111 Innovation Drive achappell@irvinecompany.com
City Irvine State CA Zip 192617 Telephone 949.720.2156
APPLICANT'S NAME
Last (Eight
Applicant's Address
18627 Brookhurst St #618
City (Fountain Valley
ARCHITECT/DESIGNER'S NAME
Architect/Designees Address
18627 Brookhurst St #618
City (Fountain Valley
ENGINEER'S NAME Last
State CA
Last Walton
State CA
First Symmetry
Applicant's E-mail Address
icity@symmetry8.com
Zip 192706 Telsphone 7'14.591.0388
First (Jennifer Lic. No, C-33627
Architect/Designer's E-mail Address
jwalton@symmetry8.com
Zip 92708 Telephone 714.591.8388
First
Lic. No.
Engineer's Address Engineer's E-mail Address
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city State F_7 Zip Telephone
CONTRACTOR'S NAME/COMPANY Lic. No, � Cias5 �
Contractor's Address I Contractor's E-mail Address
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City , 1�ve r� State 21PI Telephone �— �-
SETBACKS REAR
SETBACKS LEFT
USE ZONE
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEES $
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