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HomeMy WebLinkAboutX2021-1207 - Permit ApplicationPrint Form - Worse t for Combo Building & Solar Permit Application ozEWPoRe City of Newport Beach - Building Division xr Comm] F_ Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBIMITT�AL rBuilding F_ Grading _ rainage r-Elec F_Mech [_ Plum CuvdCut l CuYdFill F Project Address (Not mailing address) I- Flood F. Fire F_ Liq r Landslide FN/A Floor Suite No 450 Newport Center Drive Description of Work New/AddSF1 Remodel SF�— Garage/New/Add OWNER'S NAME Last kvine Company First Use F Const Type r # StoriesF_ # Units (if Res)F_ Valuation $ 20000 Material/Labor Owner's Address Owner's E-mail Address 550 Newport Center Drive City Irvine State CA Zip 92660 Telephone 949-720 2000 APPLICANT'S NAME Last First Applicant's Address Applicant's E-mail Address 3659 Green Road Suite 214 k.moe@sure site. m City Cleveland State OH Zip 44122 Telephone 310-903-8640 ARCHITECT/DESIGNER'S NAME Last SureSite Consulting Group FirstF Lic. No. Address Architect/Designer's E-mail Address 3659 1. Green Road, Suite 214 k.moe@sure-site.com City Cleveland State OH Zip 44122 Telephone 310-903 8640 ENGINEER'S NAME Last Money First Alan Lic. No. 46950 - - - - n4 Engineer's Address Engineers E-mail Address K_ 2447 West 12th Street, Suite 1 1570 City Tempe State FA; Zip 85281 TelephoneF CONTRACTOR'S NAME/COMPANY TBD Lic. No. I ClassF7 Contractor's Address Contractor's E-mail Address State F_ Zip Telephone — City F— SETBACKS REAR SETBACKS FRONT PERMIT NO. (A-14� SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $�