HomeMy WebLinkAboutXR2022-2163 - Permit Application)t Form, Worksheet for Combo Building & Solar Permit Application @560
I— Comm I F_Residential City of Newport Beach - Building Division Ana 'a1`jNOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
jX Building r Grading
rDrainage F_ Elec r Mech
r Plum Cuvd Cuts cued Fill s
Project Address (Not mailing address) r Flood r Fire F_ Liq r Landslide r_N/A Floor Suite No
520 IRIS AVE
F— F
Description of Work
Use s Const Type s
REMODEL FIRST FLOOR UNIT
# Storiess # Units (if Res)s
Valuation $ 40,000
Material/Labor
New/Add SFF_ Remodel SF 800 Garage/New/Add
OWNER'S NAME
Last MILLER
First ITOM
Owner's Address
Owner's E-mail Address
520 IRIS AVE
City CORONA DEL MAR
State CA
Zip 2625 TelephoneF
APPLICANT'S NAME
Last PETERS First IWILLIAM
Applicant's Address
Applicant's E-mail Address
33662 BRIDGEHAMPTON DR
ILLIAMAPETERS@YAHOO.COM
City DANA POINT
State CA
Zip 92629 Telephone 949-412-4428
ARCHITECT/DESIGNER'S NAME Last
First F_ �—
— Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
StateI
Zip I— TelephoneF—
ENGINEER'S NAME
Last KHAEF
First E-MAIL Lic. No. 45870
Engineer's Address
Engineer's E-mail Address
005 CALLE SONORA #2B
City LAGUNA BEACH
State CA
Zip 2637 Telephone 714-504-8260
CONTRACTOR'S NAME/COMPANY
Lic.jNNo. Class
Contractor's Address
2'f7s3y,0
Contractor's E-mail Address+� �! 5a65 7,3(-zozr
City
State F_—
Zip F— Telephoned
SETBACKS REAR
SETBACKS FRONT
PERMIT NO. ,z -O Z2-0 q 7
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO. 03rC)— ZS)ZZ
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $