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HomeMy WebLinkAboutX2021-1600 - Permit ApplicationR�'pt rrm wn1 Worksheet for Combo Building & Solar Permit Application Comm'I jX Residential City of Newport Beach - Building Division XZot I - pq 06 NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL XBuil ling F-' Grading F -Drainage [IElec Address (Not mailing 12 Poppy F7, Mech F, Plum Cu Yd Cut F _-7, Cu Yd Fill Flood r_- Fire F, Liq [i Landslide Description of Work Upgrade existing elevator to reach 3rd floor: 1. install elevator machinery, 2. install new call - New/AddSFRemodel SF16- Garage/New/Add OWNER'S NAME Owner's Address Last retzel First .1 R. 1312 Poppy City Corona Del Mar - State Ca. F_N/A Floor Suite No Use SFR 1 Const TypeB # Stories3 ' # Units (if Res)1 Valuation $ 15,000 Material/Labor - -- --- ' Owner's E-mail Address Zip 92625 J Telephone 714-810-8374 APPLICANT'S NAME Last Lushbau h g First illiam Applicant's Address Applicant's E-mail Address 17191 Citron --- -- blushbaugh@aol.com -- City Irvine- - --- State Ca Zip 82612 Telephone 949-584-2166 ARCHITECT/DESIGNER'S NAME Last Lushbau h, 17191l Citron 's Address Architect/Designer's esigner 9 First illiam Lic. No. 224867 Architect/Designer's E-mail Address it ' - -- -___-. blushbaugh@aol.com - — - - City Irvine State Ca Zip 29 Telephone 949-584-2166 92612 ENGINEER'S NAME Last N/A �; First I Lic. No.F_' Engineer's Address City State F Engineer's E-mail Address Zip L Telephone CONTRACTORS NAMEXOMPANY � � Lic. No, Idma_70 Class -- Contractor's Address Contractor's E-mail Address City State Zip - Telephone�t� ISETBACKS REAR SETBACKS FRONT SETBACKS LEFT SETBACKS RIGHT USE ZONE DEVELOPMENT NO PERMIT NO. PLAN CHECK NO. PLAN CHECK FEES $