HomeMy WebLinkAboutPV2021-036 - Permit ApplicationF4giD2l e ul3V
Print Fora, Worksheet for Combo Building & Solar Permit Application
r— Comm'I FX- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding F-, Grading
j -Drainage I-Elec F_Mech Plum CuvdCut F Cu Yd Fill F
Project Address (Not mailing address) F Flood r" Fire F_ Liq f— Landslide rN/A Floor Suite No
1212 SandCaste Dr
�— I- --
Description of Work
Use F_ Const Type F_
# Stories # Units (if Res)F_
Install modules, 2 Inver
Valuation$ 25000
Material/Labor
New/Add SF 708 Remodel SF F —
Garage/New/Add F--..--_-I
OWNER'S NAME
Last Rubin
First Joey
Owner's Address
Owner's E-mail Address
1212 Sand Castle Dr
joe@piersidegallery.com
Ci Beach
ty New ort P
j
State CA
I Zip 92625 Telephone 714-612-8787
APPLICANT'S NAME
Last Stablem
First Sam
Applicant's Address
Applicant's E-mail Address
2102 Alton Pkwy Suite B
sstablein@tesla.com
City Irvine
State CA
Zip 92606 Telephone 714-496-0688
ARCHITECT/DESIGNER'S NAME Last
First F_ Lic. No. F --'.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State
Zip f - — Telephone
ENGINEER'S NAME
Last �—
_ First--.--, Lic No.F---.----
Engineer's Address
Engineer's E-mail Address
City
State F
Zip r- - Telephone[
CONTRACTOR'S NAME/COMPANY Sam Stablein/Tesla
Lic. No. 888104 ClassC46 j
Contractor's Address
Contractor's E-mail Address
2102 Alton Pkwy
sstablein@tesla.com
City Irvine
State CAZip
92606 Telephone 714-496-0688
SETBACKS REAR
SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $