HomeMy WebLinkAboutPV2021-003 - Permit ApplicationPrtnt Form Worksheet for Combo Building & Solar Permit V 1�2i�b177�
F Comm'I Fx Residential City of Newport Beach - Building Division ppllCatiOn@(ao-,
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL rBuilding F_ Gradin
9 [Drainage F-Elec F Mech r plum
Cu Yd Cutl Cu Yd Fill
Project Address (Not mailing address) [Flood [' Fire F Liq (° Landslide F-N/A Floor 25 Vernon � Suite No
Description of Work
Use Const Type r_—
ns a o u es, nve er —
# Stories # Units (if Res)s
New/Add SF 708 Remodel SF I-- ---- Valuation 5 Garage/New/Addy---�-- 25
Material/Labor '000
OWNER'S NAME
Last Lee
Owner's Address - First Frank
25 Vernon Owner's E-mail Address
frank168@mac com
City Newport Beach
State CA Zip 92657
Telephone 949-285-8599
APPLICANT'S NAME
Last Stablein
Applicant's Address - - First Sam
2102 Alton Pkwy Suite B Applicant's E-mail Address
sstablein@tesla.com
City Irvine
State CA Zip 92606 Telephone 714-496-0688
ARCHITECT/DESIGNER'S NAME
Last
_
Architect/Designer's Address First I Lic. No. F.------------
Architect/Designees E-mail Address
City
- _ State L_,___._-_ ZiP F� .Telephoner_—__-__._._
ENGINEER'S NAME
Last
First I—._._._-_-__-_..- Lic. No.r_--_-_.__._
Engineer's Address
Engineer's E-mail Address
City
_.. State F_,_—._- Zip F____.— Telephoner_._._.___.___-.
CONTRACTOR'S NAME/COMPANY
Sam Stablein/Tesla Lic. No. 888104
Contractor's Address -- F Class C46
2102 Alton Pkwy Contractor's E-mail Address
sstablein@tesla.com
City Irvine
State CA Zip 92606 Telephone 714-496-0688
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT PERMIT NO.
SETBACKS RIGHT
USE ZONE PLAN CHECK NO. _
DEVELOPMENT NO PLAN CHECK FEES $