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HomeMy WebLinkAboutXC2023-0059 - Permit ApplicationME Print Form Worksheet for Combo Building & Solar Permit Application (K o,EPo e Comml F—Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL rBuilding F- Grading [—Drainage F Elec F—Mech r Plum CaYdCut CuYdFill F Project Address (Not mailing address) r Flood F- Fire r Liq F_ Landslide rN/A Floor Suite No 4667 MacArthur Blvd, Newport Beach, CA 92660 F Description of Work Use Teleco ConstType FVerizon is proposing modification of existing Wireless facility by installing (2)(N)MW Dish in # StoriesF # Units (if Res)F— Valuation $ F000 Material/Labor New/Add SFF— Remodel SF F Garage/New/Add F— OWNER'S NAME Last Johnson First Shelly Owner's Address Owner's E-mail Address 1300 Briston N., STE 190 City Newport Beach State CA Zip 92660 Telephone 949-476-0104 APPLICANT'S NAME Last Fsandhu First Ravinder Applicant's Address Applicant's E-mail Address 2415 Campus Dr., STE 265 rsandhu@tectonicengineering.com City Irvine State CA Zip 92612 Teleplione 949-410-1356 ARCHITECT/DESIGNER'S NAME Last First Lic. No. �— Architect/Designer's Address Architect/Designer's E-mail Address City State F— Zip F— Telephonel— ENGINEER'S NAME Last Privette First James Lic. No. C91463 Engineer's Address Engineer's E-mail Address 2415 Campus Dr., STE 265 City Irvine State CA Zip 92612 Telephone 949-502-8555 CONTRACTOR'S NAME/COMPANY TBD Lic. No. �j_ C3'4 Class j3 C, )O Contractor's Address Contractor's E-mail Address�oe� 9/5 /d✓� PEr>� ,_fs City . ISc, State � zip g"/� Telephon 3Z SETBACKS REAR SETBACKS FRONT PERMIT NO. It C' SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $