HomeMy WebLinkAboutX2019-0649 - Permit ApplicationPrint Foml� Worksheet for Combo Building $ Solar Permit Application
5Z Comm'I (— Residential N� City of Newport Beach -Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
PZBuilding [- Grading
Project Address (N
[—Drainage FX_Elec rMech r Plum Cu Yd Cutl Cu Yd Fill
00 West Coast Highway
of Work
Tenant Improvement for a dental office
[—Flood [- Fire [- Liq [- Landslide [-N/A Floor Suite No
R-203
10
Use I` Const Type A _,}
# StoriesF # Units (if Res)F_
r valuation $ ,000.00
New/Add SFI Remodel SF 1682 Garage/New/Add iMaterial/LaborF
OWNER'S NAME Last ISanjari
First IKasra
Owner's Address
Owner's E-mail Address
100 West Coast Highway, Suite R-203
City Newport Beach
StateCA Zip 92663 TelephoneF—
APPLICANT'S NAME Last Fifer
First Marty
Applicant's Address
Applicant's E-mail Address
0250 SW Acacia St, Suite 100
martyf@wearestudioplus.com
City Newport Beach
State CA Zip 92660 Telephone F951.987 9788
ARCHITECT/DESIGNER'S NAME Last
Fifer First Marty Lic. No. C-35790
Architect/Designer's Address
Architect/Designer's E-mail Address
0250 SW Acacia St, Suite 100
martyf@wearestudioplus.com
City Newport Beach
State CA Zip 92660 Telephone 951.987.9788
ENGINEER'S NAME Last
First F_ Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City
State Zip �— Telephone
CONTRACTOR'S,NAME/COMPANY CUZ y�� fl4` wCfiLic. No.�(; lC_%r Class F".01
Contractor's Address Contractor's E-mail Address
2kc C (fal47
City /1 C) V `U State I Zip 2 g/`6� Telephone S[ % �N/
SETBACKS REAR
SETBACKS LEFT
USE ZONE
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
PERMIT NO.
PLAN CHECK NO. / Q / & r Zo
PLAN CHECK FEES $
s�