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HomeMy WebLinkAboutX2021-0562 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application F Comm I ' r Residential City of Newport Beach (X Building NOTE: PLAN- Building DiVision X CHECK FEES DUE AT TIME OF SUBM T AI r 5�L Ij Grading F—Drainage [_ Elec iiroject Address (A 39 Chandon Description of Work FNew:,ron New/Add SF 119 OWNER'S NAME mailing F Mech F Flood Plum Cu Yd Cutf Cu Yd Fill F [—Fire [_ Liq F Landslide F_N/A Floor �(1vytk,0IG(GC -1 CO t�C� t lOccl F i'. 1 �r� t Remodel SFF� Garage/New/Add Last Suite No I IUse Const Type F_ #Stories # Units (if Res)[ Valuation $ Material/Labor$5,000.00 r - " First Uohn/Vanina LF39 ner's Address Chandon Owner's E-mail Address Jenkins@mac com Newport Beach — —�— State CA Zip 92657 Telephones_�-��— APPLICANT'S NAME Last oscak First Lisa Applicant's Address _. 32232 Paseo Adelatno, Ste A Applicant's E-mail Address lisa @a quatictech nolog ies. com City San Juan Ca istrano r----------"'--------- State CA _ Zip 92675... p Telephone 949-338-4189 ARCHITECT/DESIGNER'S NAME - Last First ��' ArchitecUDesigner's Address _ Lic. No. Architect/Designer's E-mail Address City r State F-- Zip Telephoner������ ENGINEER'S NAME Last Canfield ---_�_._ First Peffrey Engineer's Address -- Lic. No. C63595 1050 Campanile Engineer's E-mail Address eff@jeffcanfield.com F City Newport Beach State CAZip 192660 Telephone 949-383-8275 CONTRACTOR'S NAME/COMPANY quatic Technologies Lic. No. F7�44'1'77�---- Contractor's Address I Class A/B/C53' 32232 Paseo Adelanto, Ste A Contractor's E-mail Address ��- lisa@aquatictechnologies.com City San Juan Capistrano State CA Zip 192675 Telephone 949-493-9548 SETBACKS REAR SETBACKS LEFT iUSEZONE SETBACKS FRONT SETBACKS RIGHT DEVELOPMENT NO PERMIT NO. _X PLAN CHECK NO. i PLAN CHECK FEES $ �� I