HomeMy WebLinkAboutXR2023-0359 - Permit Applicationtin
t Form Worksheet for Combo Building & Solar Permit Application
Comm'I GZ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
DZBuilding r' Grading r—Drainage j— Elec r' Mech
PI
Address
621 Indus Street
of Work
e of kitchen
r um Cu Yd cut Cu Yd Fill
r Flood t— Fire r Liq r Landslide FN/A Floor
Suite No
r_
room. New utility room.
Use FFR Const Type I'
# StoriesF # Units (if Res)r—
New/Add SFF— Remodel SF 55 Garage/New/Add F— Valuation $ F$91,700
Material/Labor
OWNER'SNAME Last Merrell
First osh
Owner's Address
Owner's E-mail Address
182 Mesa Drive
'osh @liqu idgraphics.ty
city Newport Beach State CA
ZIP �_ — Telephone 714.742.5552
APPLICANT'S NAME Last
Applicant's Address
First
Applicants E-mail Address
2533 Greenbrier Lane
ony@marshillstudio. com
City Costa Mesa State CA Zip2626
Telephone 949.294.4026
ARCHITECT/DESIGNER'S NAME
Last ame as applicant First
Lic. No. 24376
Architect/Designer's Address Architect/Designer's E-mail Address
City State F— Zip t_ TelephoneF—
ENGINEER'SNAME Last
First— Lic No.F—
Engineer's Address
rEngineer's EE--mail Address
City State F_ Zjp I Telephone�—
CONTRACTOR'S NAME/COMPANY l.£�SLt�. Ji�v�ts= I Lic, No. (r'jC1 t{c( Class S p4 ElLg_c C_ 7 C-3t�
Contractor's Address Contractor's E-mail Address f�
CZity ddlEjS�t4t�/LhlPrgEeH
, ac
_!�S: ((�Z{�c/yni+5tJ�b
. CL "r/C State Zipz Telephone �
SETBACKS REAR
SETBACKS LEFT
USEZONE
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
PERMIT NO. X Zt7�/_ter&lz
PLAN CHECK NO.
PLAN CHECK FEES $