HomeMy WebLinkAboutXR2023-2607 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application 0106
r Comm'] DZ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
RBuilding i— Grading rDrainage r Elec r Mech
r Plum Cu vd Cut Cu Yd Fill F
Project Address (Not mailing address) F_ Flood r Fire F_ Liq F_ Landslide F_N/A Floor Suite No
123 Crystal, Newport Beach, CA 92662
�—
Description of Work
Use F—ConstType
Demolition of property
# Stories #Units (if Res)
Valuation
New/Add SFF_ Remodel SF� Garage/New/Add F_
$ FOOO
Material/Labor
OWNER'S NAME Last guyen
First Pavid
Owner's Address
Owner's E-mail Address
17272 NewHope Street Ste K
avid@keystonedcs.com
City Fountain Valley State f "'
Zip 92708 Telephone 714-791-3771
APPLICANT'S NAME Last Tang
First Natalie
Applicant's Address
Applicant's E-mail Address
17272 Newhope Street Ste 207
Natalie@keystonedcs.com
City Fountain Valley State rA
Zip 2704 Telephone 714-722-8430
ARCHITECT/DESIGNER'S NAME Last kA First F_ Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City State F___
Zip F— Telephoned
ENGINEER'S NAME Last INIA
FirstF Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City State F_
Zip F Telephoned
CONTRACTOR'S NAME/COMPANY eystone DCS, Inc.
Lic. No. F329A 5 Class and B
Contractor's Address
Contractor's E-mail Address
17272 Newhope
avid@keystonedcs.com
City Fountain Valley State F
Zip 92708 Telephone 14-791-3771
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $