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HomeMy WebLinkAboutX2021-0916 - Permit Application (2)f tfForm Worksheet for Combo Building & Solar Permit Application o �fW�a@� City, of New Beach - Building Division r Comm I Rsidential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL o. " r,Building 15 ' Grading rDrainage rElec r, Mech r, Plum CuvdCut 98 Cu Yd Fill 180 Project Address (Blot mailing address) F' Flood r' Fire r Liq r Landslide f—N/A Floor Suite No 280 Evening Canyon �_. �I Description of Work Use rR-3/U Const Type B-Spnk # StoriesF2 # Units (if Res)f 1 with a 2 -story pool house 9001 Valuation New/Add SF �� � Remodel SF Garage/New/Add 751 I 1,400,000 bor Material/Labor OWNER'S NAME Last Mendell FirstIteven & Carol Owner's Address Owner's E-mail Address -� 1280 Evening Canyon city Korona del Mar State CA Zip 92625 Telephone 949-975-0123 APPLICANT'S NAME Last Teale First Mark Applicant's Address Applicant's E-mail Address 2x900 Bristol St, Bldg A-203 mteale@tealearchitecture.com City Costa Mesa State CA Zip 92626 Telephone 949-975-0123 ARCHITECT/DESIGNER'S NAME Last ITeale First Mark�, Lic. No. C-22162 Architect/Designer's Address Architect/Designer's E-mail Address same as above City ( State F -- Zip r Telephoned ENGINEER'S NAME Last Hakim First Fady Lic. No. C-75736 Engineer's Address Engineer's E-mail Address 410 Goddard, Suite 200 adyhakim@fmhengineering.com City Irvine State CA Zip 92618 Telephone 310-422-1536 CONTRACTOR'S NAME/COMPANY Lic. NJ-,Class[— lass[Contractor's Contractor'sAddress Contractor's E-mail Address City f State F Zip [— Telephone�� SETBACKS REAR SETBACKS FRONT PERMIT NO. �e SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $