HomeMy WebLinkAboutX2018-3186 - Permit Application (2)Prin! Form Worksheet for Combo Building &Solar Permit A�iofp=lication ��W�Re
lX Residential City of Newport Beach - Building Division x �(
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL V y� l
rBuilding lX Grading IXDraina e V
9 � Elec lx Mech r plum
Project Address (Not Mailing address) f— lood r-' Fire ��Ydat �bp Eu YdFlll �
452 MENDO Liq r Landslide �
ZA TERRACE N/A Floor
E � (Suite No
Description of Work I
1 -STORY SINGLE FAMILY RE------------
SIDENCE WITH BASEMENT
New�SF14,a44
OWNERS NAME
Owner's Address
City �—
APPLICANTS NAME
Remodel SFF �
Last IBERK HOMES---`
Last
Use FR 3/U Const Type VB -SPK
# Storiess # Units (if Res)s
5
Owners E-mail Address
State s---
Zip I TelephoneF_�
Applicant's Address
First )MARK
2900 BRISTOL ST., BLDG A, SUITE 203 Applicant's E-mail Address
City COSTA MESA
State CA Zip
mteale@tealearchitecture.com
92626 Telephone
ARCHITECT/DESIGNER'S NAME
(g49) 975-0123
Last TEALE
ArchitecVDesigner's Address
First MARK
LIC. No. C-22162
Ar chitect/Designers E-mail Address
City
State -- Zip [
Telephone—
ENGINEER'S NAME
Last HAKIM
FirstFADY
Engineer's Address
Lic. No. C -C75736
410 GODDARD, SUITE 200,
Engineers E-mail Address
-----�_ _
City IRVINE
FADYHAKIM@FMHENGINEERING.COM
State CA Zip
92618 Telephone
310-42
2-1536
CONTRACTOR'S NAME/COMPANY
Contractor's Adr)ress Lic' No. r Class_ +
Contractor's E-mail Address
City
State 1�
_�_ Zip F, Telephone—
SE ACKS_okR _ � SETBACKS FRONT
SETB13ACKS LEFT
USE ZONE
SETBACKS RIGHT (�
DEVELOPMENT NO
lTm —L.
PERMIT NO.
PLAN CHECK N
PLAN CHFr'k FEES $
n �T�"