HomeMy WebLinkAboutX2022-0082 - Permit Applicationr Comm'I rk Residential unY ur tvewpurt Deaur - nuuumy uivisiun
I� NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAI
jX Building j— Grading j—Drainage r Elec r Mech r plum Cu Yd Cuts Cu Yd Fill F_
Project Address (Not mailing address) f Flood r Fire r Liq F_ Landslide FN/A Floor Suite No
15 61st St., Newport Beach, GA
F
Description of Work
Use ConstType VB
New second story ADU family
above original single residence.
# Stories25 # Units (if Res)s
Valuation 5 6,000.00
Materal/Labor
New/Add SF 51 Remodel SF�—
Garage/New/Add
OWNER'S NAME Last / d
First
iIJi n �a
Owner's Address
Owner's E-mail Address
City pew ,/, �{ , p a State �(//� zip 94, n Telephone t/9 n.5 L� /
✓7 /LLaa�stti'Blackmore I "Fiirsstt�ason
APPLICANT'S NAME
Applicant's Address
Applicant's E-mail Address
735 De Soto Ave
"abdesign@gmail.com
City osta Mesa State CA
Zip 2626 Telephone 49-274-6585
ARCHITECT/DESIGNER'S NAME Last Blackmore First pason �—
Lic No.
Architect/Designers Address
Architect/Designer's E-mail Address
735 De Soto Ave
jabdesign@gmail.com
City Costa Mesa State CA
Zip F2626 Telephone 49-274-6585
ENGINEER'S NAME LastMasoud
First afar Lic. No. 3812
Engineer's Address
Engineer's E-mail Address
3 Orchard Rd., Suite 250
m.jafad@wsase.com
Ciry Lake Forest State CA
Zip P2630 Telephone (949) 206-9929, e
CONTRACTOR'S NAME/COMPANY ,�L"')'` pn �C�� ?j _ Lic No. OUV F 7 Class
�./
JE-mail lAAdddress
Contractor's Address
Contractor's
City � / a� 141z State
Zip l � )� Telephone(
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.�,�
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $