HomeMy WebLinkAboutX2015-3753 - Permit Application (3)Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division
Comm'I Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building !� Grading f—Drainage r- Elec f— Mech F_ Plum cu vd cutr--- cu vd Fill
Flood Fie f- Liq f — Landslide [_N/A Floor Suite No
Project Address (Not mailing address) �_ r_ f
Description of Work
Use FxxConst Type
# Stories -# Units (if Res)
Valuation $
!w/Add SP Remodel SF Garage/New/Addl/wF` Material/Labor
OWNER'S NAME Last
Owner's Address ,
City State
APPLICANT'S NAME Last
Applicant's Address
First
Owner's E-mail Address
Zip I Telephone
First
Applicant's E-mail Address
City State r_ Zip �_ Telephone[-
-ARCHITECT/DESIGNER'S NAME Last j qa%� First r4eF%41 ^ Lic. No. C 8
Architect/Designer's Address Architect/Designer's E-mail Address
r-i
b tt sUnwvj4vc% CO) At^- tsM/
City �,Q VN�1 �� ye �_ State r Zip Telephon� ;6A?
J
ENGINEER'S NAME Last r4w
• +, First ,�04&420 Lic. N(".
Engineer's Address Engineer's mail Address
- _ - -
�/ Tele hone 'M
Cit ! State FF4;-
I Zip �l p
CONTRACTOR'S NAME/COMPANY Lic. No.s
Contractor's Address Contractor's E-mail Add re s
OIX
City � State Zip Fro o7v TelephoneN 7 —9$/
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
Print Form
f- Comm'l OZ Residential
Worksheet for Building Combo Permit Application
City of Newport Beach - Building Division
marr.'PLAN CHECK FEE DUE AT TIME OF SUBMITTAL
jnDuilding DZ Grading
FDrainage f Elec Ix Mech a Plum CuYdCut 746L_ ¢uYdFill
Project Address (Not availing address)
14615 Brighton Road
Floor Suite No
F— �—
Description of Work
ttsR Res
dition to an existing single
family wsidence
#F StoriesF # units (if Res)r i
Valuation $ 6,000,000
Materlal/Labor
New/Add SF 14,567 Remodel SF 0 Garage/New/Add 11,101
OWNER'S NAME
Last Shiloh, LLC
First
Owner's Address
Owner's E-mail Address
4615 Brighton Road
bmunzeli@hsventures.org
City corona Del Mar
State CA
Zip 92625 Telephone 949-419-5266
APPLICANTS NAME
Last
First
Applicant's Address
Applicant's E-mail Address
City _
State �0
Zip l a Telephone
ARCHITECT/DESIGNER'S NAME Last Ball
First Stephen Lic. No. C19781
Architect/Designer's Address
Architect/Designees E-mail Address
38 N Stonington
stephen@ballaia.com / charles@ballaia.com
City Laguna Beach
State CA
Zip 92651 Telephone 949-338-2679
ENGINEER'S NAME
Last , hh , e Cori SL&�&n. 5 t,Vf First Lic. No. F 6 ki
Engineer's Address
Engineer's E-mail Address
Z$'L5 s BtRCsA, 5=t�
S10-ec 3L.
city $Asi3►t DNA
State C
Zip cja�,'� Telephone �9 -'j(, ii — `k7
CONTRACTOR'S NAMEICOMPANY VApv1- 1, • - 0.o kct At (� otwc Class
Contractor's Address
Contractor's E-mail Address
�k1Z N1��-fit
Stv� c
M ��i� G)
City tp,� A State �®
Ixl
Zip OlL` S Telephone - ClC{tk -1311
ENERGY P/C FEE $
FIRE P/C FEE $
PERMIT NO.
GRADING P/C FEE $
PLANNING P/C FEE $
PLAN CHECK NO. ,�
IMP—
ELEC/PLUM/MECH P/C FEE $
PLAN CHECK FEE $
DEVELOPMENT#
TOTAL FEES PAID $
Print Form
(` Comrn'I r Residential
'N 6,2,� U)Q► Ap
Worksheet for Building Combo Permit Application
City of Newport Beach - Building Division
NOTE: PLAN CHECK FEE DUE AT TIME OF SUBMITTAL
j Building fX- Grading (Drainage fX Elec IR Mech R Plum Cu Yd cut 7466 Cu Yd Fill
Project Address (Not mailing address)
Floor Suite No
r4615 Brighton Road
F®
Description of Work
Use Res
# Storiesr3 # Units (if Res) 11
Valuation $
New/Add SF 14,567 Remodel SF 0 Garage/New/Add 1,101
6,000,000
Material/Labor
OWNER'S NAME Last Shiloh, LLC
First
Owner's Address
Owner's E-mail Address
4615 Brighton Road
bmunzell@hsventures.arg
City Corona Del Mar State CA
Zip 92625 Telephone 949-419-5266
APPLICANTS NAME Last
First
Applicant's Address
Applicant's E-mail Address
City State F_
Zip F_ Telephonel-
ARCHITECT/DESIGNER'S NAME Last Ball
First Stephen Lic. No. C19781
ArchitectMesigners Address
Architect/Designees E-mail Address
38 N Stonington
stephen@ballaia.com / chades@ballaia.com
City Laguna Beach State CA
Zip 92651 Telephone 949-338-2679
ENGINEER'S NAME Last Con S5 UVf FirstLic. No. bl�(
Engineer's Address
Engineers E-mail Address
2 s S BtRe�k swmN
W, -ex
City $ASN`(i� �NA State
Zip Telephone � 9 --((; 6 -LF, 7
CONTRACTOR'SNAME/COMPANY Mavl� j� �0.�CbnQ CIrvC Lic. No. Zbl�i• Class�Y
Contractors Address
Contractors E-mail Address
Ik1Z �v�rkl e Sty
M N)Aw• C Mt�E9-[
City Qsc? c�c State
ZP ZL S Telephone v - L ckk -131 k
ENERGY P/C FEE $ FIRE P/C FEE $
PERMIT NO. Z d '
PLAN CHECK NO.
GRADING P/C FEE $ PLANNING P/C FEE $
ELEC/PLUM/MECH P/C FEE $
PLAN CHECK FEE $ -7
I
DEVELOPMENT#
TOTAL FEES PAID $
o5'j.-0 3 1 i 0. L