HomeMy WebLinkAboutX2021-0767 - Permit Applicationt Fir Worksheet for Co . rnbo Building & Solar Permit . Application
F.,*Comm 'I Fx Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
nX Building F_ Grading rX-lDrainage iK. Elec F- Mech rx- Plum cu Yd cut 191..Cu Yd Fill 5
F-1.11-,
Project Address (Not mailing address) Fj Flood r- Firer Liq' J-11 Landslide." 1,N/A Floor Suite No
11 Ell Modena F777
Description of Work Use [R7-3/ I Co.nst Type B-Sprinl
New 2-story single family residence with a roof deck. F
2 # Uit(if R) ns es # StorlesF FT
Valuation
$
New/Add SF 766 Remodel SF Garage/New/Add Material/Labor OWNER'S NAME Last JGonzalez First, oe
Owners Address VW�
Owners E-mail Address
�11,_S_"o ena ... ja _ ____\
C Beach State
City Newport CA_Zip F Telephon+$��_,
APPLICANTS NAME Last eale First Mark
Applicant'sApplicant's Address Applicant's E-mail Address
900 Bristol St, Bldg. A - 203 mieale@tealearchitecture.com
. .. .............. . ......
City State [CA:Zip Telephoneh�9-7 ........ ........ .. ..
7 9 0123 ARCHITECT/DESIGNER'S NAME Last eale First [Mark Lic. No. 22162
- - - - _- --------
Architect(Designer's Address Architect/Designees E-mail Address
�same as above -- — - - ----- ----- --- ----- ---------- - -- . ...... F77
City State Zip Tel6phone
ENGINEER'S NAME Last Hakim First FFady Lic. No -7_57M
Engineer's Address Engineer's, E-mail Address
10 Goddard, Suite 200 �adyhakim@fmhengineering.com
... ... .......
ciIFyine ty State FA Zip FT B_ Telephone FIQ-422-153i
CONTRACTOR'S NAME/COMPANY I Lic. No. class
Contractor's Address -Contractor's E-mail Address
......... .... . ....... .
city State Zip Telephond
- ------- - - F
SETBACKS REAR � SETBACKS FRONT PERMIT NO. �W_7A - D-7 6-7
-)_7
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. c 05 ZGDZ4
USE ZONE DEVELOPMENT NO PLAN CHECK FEES
I