HomeMy WebLinkAboutPV2022-0313 - Permit Application?v2027_DN '�)
Printl=grrrr Worksheet for Combo Building & Solar Permit Application
F_ Comm'I rX, Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL oar
fx',Building f_; Grading f—Drainage r- Elec F_ Mech J" Plum Cu Yd cut Cu Yd Fill F'
Project Address (Not mailing address) f- Flood j— Fire F' Liq r— Landslide (SIN/A Floor Suite No
2916 CLAY STREET, NEWPORT BEACH, CA, 92663F����'
New/Add SF Remodel SF Garage/New/Add F—
OWNER'S NAME Last LOMBARDO First OANN
Owner's Address Owner's E-mail Address
Use Const Type
# Stories' # Units (if Res)[
Valuation $ 15,960
Material/Labor
916 CLAY STREET ojoannmail@gmail.com
City NEWPORT BEACH State CA Zip 92663 Telephone 949-243-5274
APPLICANT'S NAME Last iKIM First IT
Applicant's Address Applicant's E-mail Address
1211 E. LABRA BLVD STE A permits@formesolar.com
City LA HABRA State CA Zip 90631 Telephone (714) 694-2262
ARCHITECT/DESIGNER'S NAME Last First
Lic. No.
Architect/Designer's Address
city State F '
Architect/Designer's E-mail Address
Zip Telephone
ENGINEER'S NAME Last MORALES _ First DOUGLAS Lic. No.C69163
Engineer's Address
0271 LIGHTHOUSE LANE
City HUNTINGTON BEACH State CA
Engineer's E-mail Address
doug@dougengineering.com
Zip 92646 Telephone 9492855104
CONTRACTOR'S NAME/COMPANY FORME SOLAR ELECTRIC Lic. No. 1066257 Class Fa0
Contractor's Address
1211 E. LABRA BLVD. STE A
City LA HABRA State CA
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
Contractor's E-mail Address
permits@formesolar.com
Zip 90631 Telephone (714) 694-2262
PERMIT NO.
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $