HomeMy WebLinkAboutPV2020-143 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application 60-5
F Comm'I )< Residential City of Newport Beach - Building Division ` v ZO?� i Li?j �Au�
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[-Building f -Grading
I -Drainage ❑Elec Mech FPlum cuvdcut ' Cu rd Fin
Project Address (Not mailing address) [-1 Flood F- Fire r Liq r Landslide 1 N/A Floor Suite No
11 11 Jasmine Creek Drive r— j
Description of Work
Use �i Const Type n
# StoriesF # Units (if Res)F
Install modules, I inverter, 13.5 KVv energy storage system
- - -
- -- - ----- - - - - -
New/Add SF 444
Remodel SF �— Garage/New/Add F
Valuation $
Material/Labor 24 000
OWNER'S NAME
Last Duda First Brendan
Owner's Address
Owner's E-mail Address
11 Jasmine Creek Drive
I Brendan.duda@gmail.com
City Newport Beach
State CA Zip 92625 Telephone 831 236 1248
APPLICANT'S NAME
Last Stablein First Sam
Applicant's Address
Applicant's E-mail Address
2102 Alton Pkwy Suite B
sstablein@tesla.com l
—
City Irvine State CA Zip 92606 j Telephone 714-496 0688
ARCHITECT/DESIGNER'S NAME Last I First Lic. No.
Architect/Designer's Address
ArchitecNDesigner's E-mail Address
City StateZipZip Telephoned
ENGINEER'S NAME
Last - - - First F_ Lic. NoF
Engineer's Address
Engineer's E-mail Address
city
- StateF Zip r li TelephoneF
CONTRACTOR'S NAME/COMPANY Sam Stablein/Tesla Lic. No. 888104 Class C46
Contractor's Address
Contractor's E-mail Address
2102 Alton Pkwy
I
sstablein@tesla.com
City Irvine
State CA Zip 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 $