HomeMy WebLinkAboutX2021-1356 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application SS7w
'' pp City of Newport Beach, building Division
j Comm'I�p es' ential ��/
YY'�y NOTE: PLAN CHECK FEES D T E OF SUBMITTAL pr"
5f Building F_ Grading
F-Drainage FK Elec R Mech
(K Plum ft Cu Yd Fill
F_ Flood
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r Fire �iq r Lendsll' /A
Project Address (Not
mailing address)
Floor suite No
118 28th Street Newport Beach CA 92663
flAI
A Al
Description of Work
�—
onstType I�`
emo e i c en.
# Stories # Units (if Res /
Valuation
New/Add SFF
��
Remodel SF I I I t.-� Garage/New/Add
$ 9,500
Material/Labor
OWNER'SNAME
Last LI
First FiSa
Owner's Address
Owners E-mail Address
1048 Irvine Ave. #738
City lNewport Beach
State CA
Zip F Telephone 949.874.6418
APPLICANTS NAME
Last oolbert
First Craig
Applicants Address
Applicant's E-mail Address
622 Littler Drive
dhouses@gmail.com
City HB
State FA
Zip 2649 Telephone F14.856. 6605
ARCHITECT/DESIGNER'S NAME Last oolbert First Fralig Lic. No. �—
ArchitectlDesigners Address
Architect/Designers E-mail Address
622 Littler Drive
dhouses@gmail.com
City HB
State CA
Zip F2649 Telephone 14.856.2605
ENGINEER'S NAME
Last han
First Inert Lic. No. -i 1l
Engineers Address
Engineer's E-mail Address
13104 Glen Ct.
City Chino Hills
State NA
Zip F1709 Telephone F09.591.2468
CONTRACTOR'S NAME/COMPANY
Lic No. Class
Contractors Address
Contractor's E-mail Address
City
State F_
Zip F_ Telephoned
SETBACKS REAR
SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO
USEZONE
DEVELOPMENT NO
PLAN CHECKFEES$