HomeMy WebLinkAboutX2019-1038 - Permit ApplicationPant For---]Worksheet for Combo Building & Solar Permit Application
Comm'I (X Residential City of Newport Beach - Building Division x2o ` (A -, t0u )
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Foa
fX'Building (� Grading
fX Drainage fX Elec fX Mech (X Plum Cu Yd Cut Cu Yd Fill F _—
Project Address (Not mailing address) (— Flood j— Fire F_ Liq (— Landslide FN/A Floor Suite No
F207 Blue Gum Lane
r_.____
Description of Work
Use Fs FIR Contt Type
Interior Remodel
# Stories # Units (if Res)[ 1
Valuation $
Material/Labor
New/Add SFJ
—
�'
Remodel SF 00 Garage/New/Add
OWNER'S NAME
Last Khudic First Stefan
Owner's Address
Owner's E-mail Address
1207 Blue Gum Lane
Khudic@yahoo.com
City Newport Beach
State CA Zip 92660 Telephone 19-571-5661
APPLICANT'S NAME
Last Khudic First Stefan
Applicant's Address
Applicant's E-mail Address
1207 Blue Gum Lane
Khudic@yahoo.com
City Newport Beach
State CA Zip 92660 Telephone 19-571-5661
ARCHITECT/DESIGNER'S NAME
Last Pekarek First Mark Lic. No. c-29159
Arch itect/Designer's Address
Arch itect/Designer's E-mail Address
5100 Costa Rustico
mpekarek@pekarek.com
City San Clemente
State CA �Zi (2673 Tele hone194�9-4887�-2�320 : p I p 1
ENGINEER'S NAME
Last Sadler First Ken Lic No. c-4536
Engineer's Address
Engineer's E-mail Address
1800 E. 16th Street #B
Ken@esifine.com
City Santa Ana
State CA Zip 92701 Telephone 714-835-2800
CONTRACTOR'S NAME/COMPANY
Oak -Land Lic. No. 966063 Class(B
Contractor's Address
Contractor's E-mail Address
1207 N Lance Lane
igregbosweli@oaklandfireplaces.com
City Knaheim
State CA Zip 92806 Telephone 714-632-9080
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $