HomeMy WebLinkAboutXR2022-2607 - Permit ApplicationPrint.Form- Worksheet for Combo Building & Solar Permit Application ow
I— Comm'I 1c Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
IX Building r Grading rDrainage Inc Elec r Mech r Plum Cu Yd Cut F_Cu Yd Fill F_
Project Address (Not mailing address) r Flood r Fire r Liq F_ Landslide rN/A Floor Suite No
0 Ima Loa Ct. Newport Beach, Ca. 92663 �—
Description of Work
use Const Type emodel
emodel of master bathroom, kitchen
remodel, shared bathroom, powder room, and deck
# StoriesF # Units (if Res)[
aluatlon$
MaterlaVLabor
i
New/AddSF� Remodel SF Garage/New/Add
331 933
OWNER'S NAME Last rooseman First IMichael
Owner's Address Owner's E-mail Address
0 Ima Loa Ct ichael@my-abode.net
City Fewport Beach State I 49.910.1042
Zip 2663 Telephone
APPLICANTS NAME Last itchell First ordan
Applicant's Address Applicant's E-mail Address
400 E Katella Ave Ste 800 m@lstchoicedevelopment.com
City rnaheim State FK---Zip p 2806 p 4429237D0
Zi Tele hone
ARCHITECT/DESIGNER'S NAME Last First —
�—
Lic. No.
ArchitecVDesigner's Address Architect(Designer's E-mail Address
City State �— Zip F_ Telephoned
ENGINEER'S NAME Last First �— Lic. No.F—
Engineer's Address Engineer's E-mail Address
City State F— Zip �— Telephoned
CONTRACTOR'S NAME/COMPANY &-9evel Lic. No./ Class
��tlyl r0 G11Slr✓G�1�+' .e rJiCPS IU/2y S(,
Contractor's Address / Contractor's E-mail Address
2-COZ 6, c l&rA A,K,i}pf L- 3 5c. n JO V. CD ) Mt 0
City An �x � �/ 40_� State ' rf Zip
7 s�/�
Z 70 5 Telephone ,71 �� -
/I V-
SETBACKS REAR SETBACKS FRO---NT PERMIT NO. Xa 2627-107
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. j C:072-2H 39
'-St LONE DEVELOPMENT NO PLAN CHECK FEES $