HomeMy WebLinkAboutX2021-1218 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
[— Comm I PC Residential City of Newport Beach - Building Division X20,2' ^ TI 8
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
RBuilding rGrading
rDrainage [Elec (-"Meth Plum Cu Yd cutF Cu Yd Fill
Project Address (Not mailing address) C Flood r Fire r Liq j— Landslide rN/A Floor Suite No
21 Shadowcast
F— F—
in I
Description of Work
Use F Const Type F-
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# Stodesr # Units (if Res)[
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I t2O hJ MZ -CUA +O '7yF6L FiS'I �%1 �tf}
New/Add SFF
Remodel SF Garage/New/Add F—
Valuation 5
MateriaVLabor J
OWNER'S NAME
last Clark First
Owner's Address
Owners E-mail Address
21 Shadowcast
City Newport Coast
State Ca Zip 92657 Telephone 714.232.2581
APPLICANTS NAME
Last Ellison First Paul
Applicant's Address
Applicant's E-mail Address
24642 Via Raza
paul@dpspennits.com
City Lake Forest
State Ca Zip 92630 Telephone 949.683.9861
ARCHfTECT/DESIGNER'S NAME Last FirstF Lic. No.
Architecf/Designer's Address
Architect/Designer's E-mail Address
City
State �— Zip F— Telephone—'
ENGINEER'S NAME
Last Burke First Thomas Uc.No.5088
Engineers Address
Engineer's E-mail Address
151 Kalmus Dr E-140
City Costa Mesa
State Ca Zip 92626 Telephone657.289.0460
CONTRACTOR'S NAMEICOMPANY J Vaughn Construction Lic. No. 783765 Class IB —
Contractor's Address
Contractor's E-mail Address
309 Durian St
City Vista
State Ca Zip 92083 Telephone 949.456.5810
y
SETBACKS REAR
SETBACKS FRONT PERMIT NO_ V�
SETBACKS LEFT
SETBACKS RIG PLAN CHECK NO. C
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $