HomeMy WebLinkAboutX2019-0652 - Permit ApplicationN1
f 9 pp
.:Print Form Worksheet for Combo Building &Solar Permit Application
Comm'( r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
FX'Building F Grading
Address (Not mailing
F—Elec rMech I—plumCu Yd Cutr--' Cu Yd Fill
127 Gardenia Way, Corona Del Mar, CA
Description of Work
F Flood F- Fire F— Liq F_ Landslide
u
New/Add SFr-- Remodel SFW'sz Garage/New/Add
Floor Suite No
Use MDR Const Type VB
# Storiesv— # Units (if Resf 1
Valuation$
Material/Labor
OWNER'S NAME Last (Ruane
First Michael and Jayne
Owner's Address Owner's E-mail Address
827 Gardenia Way
ayneruane@gmail.com
City Corona Del Mar State CA Zip 92625
of Telephoner
APPLICANT'S NAME Last (Shipley
Applicant's Address
30386 Esperanza
City Rancho Santa Margarita State CA
First (Beth
Applicant's E-mail Address
beth@d umonteng i neeri ng. com
Zip 92688 Telephone 949-709-5300
ARCHITECT/DESIGNER'S NAME Last Gaudet
---`i First estin Lic. No. F--
Architect/Designer's Address ArchitecVDesigner's E-mail Address
30386 Esperanza estin@dumontengineering.com
City Rancho Santa Margarita State CA Zip 92688 Telephone 949-709-5300
ENGINEER'S NAME Last Du Mont First Kevin
—_---Lic. No. C054083
Engineer's Address Engineer's E-mail Address
30386 Esperanza kevin@dumontengineering.com
City Rancho Santa Margarita State CA Zip 92688 Telephone 949-709-5300
CONTRACTOR'S NAME/COMPANYRC2 J� r `/ ' Lic. No. Class 53
Contractor's Address Contractor's E-mail Address
c ct r fr� TQC« iMe< < . coeCA
City � �r y� jy� r �Lc State �— Zip 726 q� Telephone 7/tl Shy yl
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEES $