HomeMy WebLinkAboutX2022-1578 - Permit ApplicationPrint Worksheet for Combo Building & Solar permit application ?fw�
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Comm'I Cx Residential City of Newport Beach - Building Division o
NOTE: PLAN CHECK FEES DUE T TIME OF SUBMITTAL
rx—Building F Grading g Ml0000
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Plu vdC
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Project Address (Not mailing address) r Fd
r Fire Lif`>Fu4 ide [—N/A Floor quite No
I2215 PACIFIC DRIVE .�� r�'�
� In/a n/a
Description of Work
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Use SFD Type VB
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REPAIR EXIST! WA I ER DAMAGED DtCKI;, 6 s15 , F I
iesr Units (if Res)I
Valuation
New/Add SFI— Remodel5F 653 Garage/New/Add �—
$ 30 000
Material/Labor '
OWNER'S NAME Last NING
First MR.
Owners Address
1
Owners E-mail Address
2215 PACIFIC DRIVE
NjA
City CORONA DEL MAR State CA
Zip 92625 Telephone
APPLICANT'S NAME Last NIELSEN
First�PHIL I
Applicant's Address
Applicant's E-mail Address
6131 ANACAPA DRIVE
philnielsen00@yahoo.com
City HUNTINGTON BEACH State CA
Zip 92647 Telephone (714) 717-1418
I
ARCHITECT/DESIGNER'S NAME Last NIELSEN First[PH IL Lic. No. DESIGNER
Architect/Designers Address
Architect/Designer's E-mail Address
6131 ANACAPADRIVE
phiinielsen00@yahoo.com
City !HUNTINGTON BEACH State EA7
Zip 92647 Teleohonel(714) 7i 17-1418 I
ENGINEER'S NAME Last MANSHADI
First FARHAD Lic. No. C 36840
Engineers Address
Engineers E-mail Address
14800 E. 16TH STREET
N/A 1
City SANTAANA State CA
Zip 92701 Telephone (714) 835-2800
CONTRACTOR'S NAME/COMPANY _ n ) Lic. No. / //67S f Class I —
G i VF C, ting, a,J rk C -�^_
Contractor's, Address
Contractors E-mail Address
�KJ Ci nth d i
Seb�Jfiic�,. '� .1t17 rc�C�,,c l'r/n. 60n
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City /lid/ � State Gy
Zip rJZ�6: Telephone 9�7z3-6Nyi
J
KS REAR SETBACKS FRONT
PERMIT NO.
SLEFT SETBACKS RIGHT
40�E
PLAN CHECK N . s
DEVELOPMENT NO
PLAN CHECK FEES $