HomeMy WebLinkAboutX2022-0333 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar PAWp1(1iktionV
F_ Comm'I r Residential City PoDivision
ion
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
FX -Building I— Grading
F -Drainage r Elec r Mech r Plum Cu Yd curl Cu Yd Fill
Project Address (Not mailing address) F_ Flood I— Fire i— Liq I— Landslide rN/A Floor Suite No
7200 W OCEAN FRONT
F_ �—
Description of Work
Use R -3/U Const Type FB
# Stories F2 # Units (if Res)F
REPAIR OF DAMAGES CAUSED By vEHICtt: 110PACI
Valuation S 5,000
Material/Labor
New/Add SF�— Remodel SF�—
Garage/New/Add
OWNER'S NAME
Last PHILLIPS
First JENNIFER
Owner's Address
Owner's E-mail Address
City
State Zip I Telephone209-769-0688
APPLICANT'S NAME
Last HOKAMA
First MIKE
Applicant's Address
Applicant's E-mail Address
180 E MAIN ST, SUITE 201
hchansen@msn.com
City TUSTIN
State CAZip
92780 Telephone 714-573-0073
ARCHITECT/DESIGNER'S NAME Last
First F Lic. No. I
Architect/Designer's Address
Architect/Designer's E-mail Address
City �
State �—
Zip [_ TelephoneF_
ENGINEER'S NAME
Last HOKAMA
First MIKE Lic. No.S 4505
Engineer's Address
Engineer's E-mail Address
180 E MAIN ST, SUITE 201
hchansen@msn.com
City TUSTIN
State CA
Zip 92780 Telephone 714-573-0073
CONTRACTOR'S NAME/COMPANY
TBD
No. � Class
Contractor's Address
Cont ctor's E-mail Addr ss
\zip
City
State F_
[_ Telephone
SETBACKS REAR
SETBACKS FRONT
PERMIT NO. 20 n oZ 3 3
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO. V 2CIrl - Z027,
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $ t 9 Z , 0-7