HomeMy WebLinkAboutX2019-0935 - Permit ApplicationPrtrft Fvrm I Worksheet for Building Combo Permit Application
F_ Comm'I f Residential °� ZDiq ' �q3S City of Newport Beach -Building Division LG o�._
NOTE: PLAN CHECK FEE DUE AT TIME OF SUBMITTAL
jz;Bu:lding (X Grading F -Drainage F_-_:Elec [:Meeh r Plum Cu Yd Cut 46 Cu Yd Fill 0
Project Address (Not mailing address) C4-2o1S-05zav Floor Suite No
17 CAMBRIA DRIVE, CORONA DEL MAR, CA 92625
Description of Work ((yam{,
Use
DEMO. EXISTING STRUCTURE AND BUILT NEW 1 -STORY SINGLE FAMILY RESIDENCE APPROX.
4,124 SOFT TO BE WOOD FRAMED, SLAB ON GRADE. HAVE 4 BEDRM/4.5 BATHS, 3 -CAR GARAGE, {
#Stories[, #Units (if Res)
GREAT ROOM, KITCHEN, DINING AND A CASITA
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- -UNDRY,
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Valuation $ [790,40CNew/Add
Material/Labo
SF 3436 Remodel SF F Garage/New/Add 688
OWNER'S NAME Last ENGLER First GREG & MONICA
Owner's Address Owner's E-mail Address
2275 BLACKHEATH TRACE I
City ALPHARETTA State GA Zip 30005 Telep hone 770.777.2670
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APPLICANT'S NAME Last JOHNSTON :, First JUSTIN
Applicant's Address Applicant's E-mail Address
151 KALMUS DRIVE, SUITE G-1 JUSTIN@BRANDONARCHITECTS.COM
Ciry COSTA MESA State CA Zip 92626 Telephone 714.754.4040/105
ARCHITECT/DESIGNER'S NAME Last BRANDON First CHRISTOPHERI
Lic. No. C731637
Architect/Designer's Address Architect/Designer's E-mail Address
151 KALMUS DRIVE, SUITE G-1
Ciry COSTA MESA I State CA Zip 92626 Telephone—
ENGINEER'S NAME Last MANSHADI FirstFARHAD Lic. No. 36840
Engineer's Address Engineer's E-mail Address
1800 E. 16TH ST., STE. B
Zip 92701 Telephone 714.835.2800
City SANTA ANA State F77
CONTRACTOR'S NAME/COMPANY Lic. No. ��IZ�o�Y! Class 4�-f
Contractor's Address Contractor's E-mail Address
City V�TtV�_ . StateI "'' Zip
.i��...... TelephoneF7�7
! P/C FEE $
G P/C FEE $
'JM/MECH P/C FEE $
ENT #
FIRE P/C FEE $
PLANNING P/C FEE $
PERMIT NO. XZ��a•
PLAN CHECK NO.
PLAN CHECK FEE $ ter c�Z�
TOTAL FEES PAID $