HomeMy WebLinkAboutX2021-0915 - Permit Application" I �- rWIv Urlt-LA 1-tLS DUE AT TIME OF SUBMITTAL
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180
Project Addr"s (Not mailing address) F_ Flood
F_ Fire F_ Liq F Landslide f_N/A Floor Suite No
280, - - E . v eni I ng - Can . yon - IWO Y001 0.
F7
Description of'Work
tory S, gl�famlly residence Use R 3 Const New 2 -story single family residence Use FR -3/U7, Const Type
Stories
Te # U
V� 0�jq, " �L # t I
Mkjy� # StoriesF # Units (if Resf 1
7_9
New/Add SF Remodel SF
F;;�q53�; F Garage/New/Add F75�1:1
OWNER'S NAME Last
Owner's Address
80 Evening Canyon
City Corona del �Mar State CA
APPLICANT'S NAME Last
Applicant's Address
OX ElnWol St, Bldg A-2-203 ------
city
_Costa Mesa State CA
. ... . ..... . .....
First
ven & Carol
Owner's E-mail Address
Zip
Valuation $
,4
Material/Labor F 00,000
First Mark
Applicant's E-mail Address
iMteale@tealearchitecture.com
Zip Telephone 19-975-0123
Last re I al I e First IMark
Architect/Designer's Address
�DOVe ArchitecYDesigners E-mail Address
same as
Lic. No. FC -22162
City
Slate
Zip Telephone I
- - - -------
------- - ---- -- F.- . ......
ENGINEER'S NAME Last Hakirrl First
Hakim ..... . Facly
I F Lic. No. C-75736
Engineer's Address - ------
10 Goddard, Suite 260 -------------- Engineer's E-mail Address
------ . ....... . ... ---------- dyhakim@fmhengineering.com
City State FA Zip 92618 Telephone310-422-1536- - i
- - --------- 111
wVJ I KAL I UW5 NAME/COMPANY
Contractor's Address
City State
SETBACKS REAR 61 SETBACKS FRONT
SETBACKS LEFT b SETBACKS RIGHT
USE ZONE ?,-1-bomb DEVELOPMENT NO
Lic. No. lass
F -51m: FV
Contractors E-mail Address
Zip
�-- Telephone
I
PERMIT NO.
PLAN CHECK I
PLAN CHECK FEES $