HomeMy WebLinkAboutX2021-1218 - Permit Application (2)P�nr Form Worksheet for Combo Building S Solar Permit Application
(- Comm'I OZ Residential City of Newport Beach - Building Division x2v*11- 12.1 19
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
0CBuilding r- Grading F -Drainage F-Elec F-Mech X Plum Cu Yd curF— Cu Yd Fill
Address
Shadowcast
(Not mailing address) r Flood j— Fire r Liq r Landslide FWA Floor
Description of Work l ~
4' -RIpCe- L,34 -W- 45 I -F w w;;� F6�'VP-R-
IRotJ Mk -cu4- 1c) TKU, F 6f,';T4*IDIJ4
New/Add SFF Remodel SF F Garage/New/Add
OWNER'S NAME Last
Owner's Address
First
Owner's E-mail Address
Suite No
User—ConstType�
# Stories[ # Units (if Res)'
lor 1 710, 00D
I
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
ARCHITECT/DESIGNER'S NAME Last First F —
Lic. No.
ArchitectlDesigners Address Architect/Designers E-mail Address
City State F— Zip F Telephone[
ENGINEER'S NAME Last Burke First Thomas Lic No. 5088
Engineer's Address Engineer's E-mail Address
151 Kalmus Dr E-140
City Costa Mesa State Ca Zip 92626 Telephone 657.289.0460
CONTRACTOR'S NAME/COMPANY IJ Vaughn Construction
Lic. No. 783765 ClassFB
Contractor's Address Contractors E-mail Address
309 Durian St
City Vista State Ca Zip 92083 Telephone949,456.5810
SETBACKS REAR
SETBACKS LEFT
USE ZONE
SETBACKS FRONT
PERMIT NO. _
SETBACKS RIGPLAN CHECK NO.
DEVELOPMENT NO PLAN CHECK FEES $