HomeMy WebLinkAboutPV2021-026 - Permit Application (2)2U�� ®D2[9
Print Form' Worksheet for Combo Building & Solar Permit Application"�"m
Comm'( City of Newport Beach - Building Division
r (— Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL w.."
rBuilding r Grading rDrainage r Elec rMech r' Plum Cu Yd CutF Cu Yd Fill
Project Address (Not mailing address) r Flood r Fire r Liq r Landslide rN/A Floor Suite No
313 Fullerton Ave F_
Description of Work Use F ConstType F_
QoOF 11'(4dt✓7t"� ,0-Y 17 M (1n #Stories #Units(ifResf-
Valuation$ 12000
New/Add SF 313 Remodel SF F Garage/New/Add �' Material/Labor
OWNER'S NAME Last(Harden First ITerry
Owner's Address Owner's E-mail Address
313 Fullerton Ave gtharden@gmail.com
City Newport Beach State CA Zip 92663 Telephone 9492467000
APPLICANT'S NAME Last (Fisher First (Jonah
Applicant's Address
2102 Alton Pkwy
City Irvine State CA
Applicant's E-mail Address
jonfisher@tesla.com
Zip 92606 Telephone 9498129325
ARCHITECT/DESIGNER'S NAME Last _ (:A a lh _ _ FirstFd a �&Y-IVA Lic. No.
Architect/Designer's Address
City State r_.:
Architect/Designer's E-mail Address
Zip TelephoneF
ENGINEER'S NAME Last First F__ Lic No.F—
Engineer's Address Engineer's E-mail Address
City State F Zip F Telephoned
CONTRACTOR'$ NAME/COMPANY Jonah Fisher/Tesla Lic. No. 888104 Class C46
Contractor's Address
2102 Alton Pkwy * 8
City Irvine State CA
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT
USE ZONE
SETBACKS RIGHT
DEVELOPMENT NO
Contractor's E-mail Address
jonfisher@tesla.com
Zip 92606 Telephone 9498129325
PERMIT NO. �N * "12174'1
PLAN CHECK NO.� ✓ V " I'
PLAN CHECK FEES $