HomeMy WebLinkAboutX2021-0894 - Permit Applicationp •0rm Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Divisiory 114, 0C1�9
FComn. ll � Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding Grading F-Drainage f—Elec (—Mech Plum CuYdCut CuYdFillF
act Address (Not mailing address) F_ Flood F_ Fire F Liq F Landslide j—N/A r—Floor
a
ocean Vista I
of Work
New/Add SF IO Remodel SF
Garage/New/Add f
Suite No
Use F Const Type F
# Stories[ # Units (if Res)
Valuation $ a�
Material/Labor 5 tt VIf I
OWNER'S NAME Last,Johansson First IKlmoeny
Owners Address Owners E-mail Address
32 Ocean Vista johanssoncbsa@cox.net
City Newport Beach State CA Zip 92626 TelephoneF—
APPLICANT'S NAME Last I Kemmerer First
Applicant's Address Applicant's E-mail Address
228 Crest Ave marcus@kdarch.com
City Huntington Beach State CA Zip 92648 Telephone 714.752.0052
ARCHITECT/DESIGNER'S NAME Last Kemmerer FirstrMarcus Lic. No. C-29552
Architect/Designees Address Architect/Designers E-mail Address
228 Crest Ave marcus@kdarch.com
City Huntington Beach State CA Zip 92648 Telephone 714.752.0052
ENGINEER'S NAME Last First Is� ®—® Lic. No.F_
Engineer's Address Engineers E-mail Address
City State Zip �— Telephoned
CONTRACTOR'S NAME/COMPANY Lic. N Class
Contractors Address Contractors E-mail Address y�g3'
State �— Zip— Telephoner `/�`
City X:wd*.i,
SETBACKS REAR
SETBACKS FRONT
PERMIT NO.
cTBACKSLEFT
SETBACKS RIGHT
PLAN CHECK NO.
'ONE DEVELOPMENT NO PLAN CHECK FEES`S %—I