HomeMy WebLinkAboutX2021-0595 - Permit Application (3)/Print Form Worksheet for Combo Building & Solar Per It Application
/ City of Newport Beach - Building Division
ri Comm'I r Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
r,Building r_ Grading F-Drainage n Elec
Project Address (Not mailing addrea
4607 Dorchester
Description of Work
New 1-story single family residence
r Mech r Plum cu
F- Flood r; Fire r Liq r Landslide
Remodel SF F�-;
OWNER'S NAME Last
Owner's Address
607 Dorchester Rd. _ _.
City Corona del Mar State CA
APPLICANT'S NAME Last
First IMichael & Diane
Owner's E-mail Address
Zip
Cu Yd Fill
4
r-N/A Floor Suite No
— I II
Use R-3/U ConstType B-Sprk
# Stories # Units (if Res)r 1
Valuation $
Applicant's Address
Applicant's E-mail Address
900 Bristol -Bldg A-203
mteale@tealearchitecture.com
J'
State CA
Zip 92626 Telephone
949-975-0123
City
Costa Mesa
ARCHITECT/DESIGNER'S NAME
Last eale
First
Mark Lic. No. C 22162
ArchitectlDesigner's Address
Architect/Designer'sE-mail Address
see above
._------_'_'_'
State ��
Zip
-
Telephone '.......
City
.I
Lic. No. C77167
ELast
ENGINEER'S NAME
Israel
First
Michael
Engineer's Address
Engineer's E-mail Address
5927 Balfour Ct
mike@coastlineenginc.com
JJ,
State CA
Zip
92008 Telephone
60-436-1344
City
Carlsbad
Lic. No. 871y�Class���
CONTRACTOR'S NAME/COMPANY
Contractor's Address
Contractor's E-mail Address
,
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City dG%/�%� State �-
Zip
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SETBACKS REAR
SETBACKS FRONT
PIT NO.
ERM
PLAN CHECK NO. 05511
SETBACKS LEFT
SETBACKS RIGHT
^ 1��USE
NO +U �U '�1V' PLAN CHECK FEES $
ZONE
DEVELOPMENT