HomeMy WebLinkAboutXR2022-3261 - Permit ApplicationPrint Form 1 Worksheet for Combo Building & Solar Permit Application o4?Ew�„e
r, Comm I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding F7Grading F-Drainage *Elec ]—Mech 'Plum CuYdCut F CuYdFill F_
Project Address (Not mailing address) Flood r Fire r' Liq r Landslide FN/A Floor Suite No
59 JASMINE CREEK DR
Description of Work
Use Const Type
AMW
M F R ALT: REMOVE INT WALL @ DINING/FAMILY ROOM.
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T
# Stories Units (if Res
A n �• _ I ���! �� �c 44 14, We n t
P
...u.F--X,1iC...... ._—Gc-C.X-X-----__...------------- .----....- . ..... ......... ..........
New/AddSFF77777 RemodelSFF7777 Garage/New/Add I
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Valuation $� 0
Material/Labor
OWNER'S NAME Last RIPOLI First MASUMI
Owner's Address Owner's E-mail Address
59 JASMINE CREEK D.R MASUMIUSA@GMAILCOM
City [NEWPORT BEACH State CA Zip 92625 Telephone (213) 500-6114
APPLICANT'S NAME Last HAHN First PRYN
Applicant's Address Applicant's E-mail Address
34167 PACIFIC COAST HWY Unit: D
City DANA POINTE I State CA Zip 92629 Telephone
ARCHITECT/DESIGNER'S NAME Last First r
Lic. No. I
Architect/Designer's Address Architect/Designers E-mail Address
I
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City State � Zip Telephoned!
ENGINEER'S NAME Last BURKE First LEO Lic NoF
Engineers Address Engineers E-mail Address
34167 PACIFIC COAST HWY Unit: D
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Ci DANA POINTE State CA Zip 2629 Telephone
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CONTRACTOR'S NAME/COMPANY Lic No.F7777 Class,
Contractor's Address Contractor's E-mail Address
City State F Zip �I Telephoned
SETBACKS REAR SETBACKS FRONT PERMIT NO. X�Z�%lZ • 32 61
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $