HomeMy WebLinkAboutX2021-3453 - Permit ApplicationPrint Form
Worksheet for Combo Building & Solar Permit Application
oR.City
Comm'I rX Residentia
NOTE:
of Newport Beach - Building Divi on
PLAN CHECK FEES DUE AT TIME 0 ITTAL
(,d
XBuilding r Grading Drainage X Elec r Mech Plum cuvdcuc 0 iS� cuvdFill
Project Address (Not g address) Flood r Fire Liq r Landslidei/t Floor Suite No
�(
213 Topaz Avenue
P71-�
j
Q/v V /® 1
Description of Work
uplex Const
# Stories 21 s # Units (if Res)F
nda d a nn�ewbathroom and closet /
Remodel enlarge an existing bedroom and a
New/Add SF 219 /G�R model SF 80 b�
�
Garage/New/Add l o
Valuation $ F$1501000
Material/Labor
OWNER'S NAME Last Dollander
First Tim
Owner's Address
Owner's E-mail Address
213 Topaz Avenue
City I Balboa Island State CA Zip 92662 Telephone 949.988.4175
APPLICANT'S NAME Last Walker
First Barry
Applicant's Address
Applicant's E-mail Address
P.O. Box 11658
Bwarch.biz@gmail.com
City Newport Beach State CA
Zip 92658 Telephone 949.246.4085
ARCHITECT/DESIGNER'S NAME Last Walker First Barry Lic. No. 19637
Architect/Designer's Address
Architect/Designer's E-mail Address
as above
City State F_
Zip F— Telephone F—
ENGINEER'S NAME Last Groverman
First David Lic. No. C043663
Engineers Address
Engineers E-mail Address
541 Bucknom Drive
dgroverman@aol.com
City Hailey State ID
Zip ,83333 Telephone 949.500.0652
CONTRACTOR'S NAME/COMPANY f
�
Li
c No. 746 ��3 Class FTv�T
�'- 1��7 1, -��1Li C ,
Contractor's Address
Contractor's E-mail Address
Izc 2x, ; le : o ) c _,� (,�D wvgi / cry
City State C�
Zip -/ �b �c ( Telephone I Cate
/
° �J
SETBACKS REAR SETBACKS FRONT
PERMIT NO. ✓
'ETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.�/ '
ZONE DEVELOPMENT NO
PLAN CHECK FEES $