HomeMy WebLinkAboutX2021-1325 - Permit ApplicationPrint Form N Wor et for Combo Building & Solar Permit Applietation �� °�
r Comm'I r> -(,Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL ZOZI ' GyrOPHP
RBuilding rGradingrainage
FElec I - Meth r Plum CuvdCut F__ CuvdFill F_
Project Address (Not mailing address) C Flood F- Fire rl Liq F' Landslide rN/A Floor Suite No
1200 Essex Lane
Description of Work
Use Const Type
75' long x 6'-6',8" high block wall on property line.
# Stories # Units (if Res)s
New/Add SF
Remodel SF Garag a/New/AddF—
Valuation $
Material/Labor
_
OWNER'S NAME
Last Taylor i
First I—
Owner's Address
Owner's E-mail Address
1200 Essex Lane
City Newport Beach
State CA
Zip r, Telephone
APPLICANT'S NAME
Last First
Applicant's Address
Applicant's E-mail Address
City State Zip �- Telephone—,
ARCHITECT/DESIGNER'S NA ME Last First F No. �-
_
Lic.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State F Zip Telephones
ENGINEER'S NAME
Last Lacher First Todd Lic. No. 67656
Engineer's Address
Engineer's E-mail Address
1201 N, Tustin Ave
City Anaheim
State CA Zip ephone
CONTRACTOR'S NAME/COMPANY Mata Construction Co. Inc Lic. No. 861880 ClassC29,C2
Contractor's Address
Contractor's E-mail Address
910 E. 4th St
Cit y Santa Ana
CA p 92701 714-393-t 358
State Zi Telephone
/
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT �— PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO r 414N CHECK FEES $