HomeMy WebLinkAboutX2021-1976 - Permit Application (3)Print Form Worksheet for Combo Building & Solar Permit Application / ®r,��Vymy,,,Comm'I Residential City of Newport Beach - Building Division1\\�1bNOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F—Building 7_ Grading —Drainage 7 Elec r Mech
RPlum Cu Yd Cut Cu Yd Fill F
Project Address (Not mailing address) F_ Flood
r Fire F— Liq r Landslide rN/A Floor Suite No
4699 Jamboree Road & 5190 Campus Drive
I I
Description of Work
Use FB — Const Type V-B &b
# Stories # Units (if Res)F_
MUllaUlIlLaL�U WIU��aping and new irrigation alovig Campus Drive
and jarnburee Road
Valuation $
New/Add SFr— Remodel SF 9,965 Garage/New/Add �—
100,000
Material/Labor
OWNER'S NAME Last
First
Owner's Address
Owners E-mail Address
City State F_
Zip F— TelephoneF—
APPLICANTS NAME Last Kreutzer
First Matthew
Applicant's Address
Applicant's E-mail Address
300 Spectrum Center Drive, Suite 730
mkreutzer@boulderassociates.com
City Irvine State CA
Zip 92618 Telephone 9497279000
ARCHITECT/DESIGNER'S NAME Last Hernandez First Darci Lic. No. 330188
ArchitecttDesigner's Address
Architect/Designers E-mail Address
300 Spectrum Center Drive, Suite 730
dhernandez@boulderassociates.com
City Irvine State CA
Zip 92618 Telephone 9497279000
ENGINEER'S NAME Last
First Lic. No.F—
Engineers Address
Engineer's E-mail Address
City State F___
Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY
Lic. No. F-- Class
Contractor's Address
Contractors E-mail Address
City State F
Zip F Telephone
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $