HomeMy WebLinkAboutX2020-2196 - Permit Application-.- If --1 VV P—, ` -4—/ "c( l'i�C/l Dr -
Worksheet for Combo Building & Solar Permit Application
F Comm'I F. Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding F-,, Grading nDrainage rX,,Elec Mech
[j Plum Cu Yd cut j Cu Yd Pill
Address (Not mailing address) (I' Flood n Fire F-, Liq F Landslide
527 Fairfield
ription of Work
and replace Kitchen,
)r, add barbeque area.
interior walls to create pantry and bar area,
❑N/A Floor
Suite No
J e
walls and Use SFR Const Typ
# Stories1 # Units (if Res)7,
- -
New/Add SFF Remodel SF 1,550 Garage/New/Add
OWNER'SNAME Last
First
Owner's Address —_--
Owner's E-mail Address
4527 Fairfield
City Newport Beach State Ca.
— - Zip 92625 ` Te
APPLICANT'S NAME Last Lushbau h
9 FirstWilliam
Valuation $ F125,000
Material/Labor
Applicant's Address -----"------------ --
Applicant's E-mail Address
17191 Citron
-- - I blushbaugh@aol.com
City Irvine - - _. - -- - -
State [Ca.Zip 92612 Telephone 949-584-2166
ARCHITECT/DESIGNER'S NAME Last Lushbau h
.g I. First William � Lic. No. C24867 -
Architect/Designer's Address Architect/Designer's E-mail Address
7
11911 Citron blushbaugh@aol.com
City Irvine
State Ca Zip 92612 I Telephone 949-584 2166
ENGINEER'S NAMELast Jamil First Bashar _ J
Lic. No. C83129
Engineer's Address -
Engineer's E-mail Address
751 Shasta Dr.
CityCorona —
State Ca. Zip 92881 Telephone 714 883-4124_ _
CONTRACTOR'S NAME/COMPANY
f /�SZV/n t'sb l� Lic. No. AAOZZ7�701 Class FS7
Contractor's Address
Owl M COtz,4J w�7
City "14 u1L,�� - State r
SETBACKS REAR SETBACKS FRONT
Contractor's E-mail Address
Zip /v D 7 Telephone � v L/57 '15W .. _.
PERMIT NO. X (-i )-Y)'�-
SETBACKS LEFT SETBACKS RIGHT —��
PLAN CHECK NO. '-j
USE ZONE DEVELOPMENT NO I ---I O r d 1i >PLAN CHECK FEES $ +-�