HomeMy WebLinkAboutPV2020-196 - Permit ApplicationPrint Formr Worksheet for Combo Building & Solar Permit Application
F_ q
Comm'I Residential City of Newport Beach - Building Division JtiOtiONOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAI
F -Building F_ Grading
@`Drainage F_Elec rMech [`Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood F- Fire F_ Liq r- Landslide FN/A Floor Suite No
4 Twin Lakes Circle
w F
Description of Work
Use Const Type
# Storiesr2 # Units (if Res)F—
Install mo u es, Inve er
Valuation $
Material/Labo0('Z-c>
01 7
New/Add SF 944 Remodel SFF—
Garage/New/Add—
OWNER'S NAME
Last Paglia
First Kimm
Owner's Address
Owner's E-mail Address
4 Twin Lakes Circle
michelle@protechconstruction.com
City Newport Beach
StateCA Zip 92625 Telephone 714-698-3398
APPLICANT'S NAME
Last Stablein
First Sam
Applicant's Address
Applicant's E-mail Address
2102 Alton Pkwy Suite B
sstablein@tesla.com
City Irvine
State CA
Zip 92606 Telephone 714-496-0688
ARCHITECT/DESIGNER'S NAME Last F—
First F— Lic. No. F_
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State F
Zip �— Telephone—
ENGINEER'S NAME
Last
First F— Lic. No.[ --
Engineer's Address
Engineer's E-mail Address
City
State F_
zip F— Telephoner
CONTRACTOR'S NAME/COMPANY Sam Stablein/Tesla
Lic No. 888104 Class C46
Contractor's Address
Contractor's E-mail Address
2102 Alton Pkwy
sstablein@tesla.com
City Irvine
State CA
Zip 92606 Telephone 714-496-0688
SETBACKS REAR
SETBACKS FRONT
PERMIT N0. �7y Z O LO — vi 6
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $