HomeMy WebLinkAboutX2021-0916 - Permit Application.ni Form __ll
F/, Residential
Worksheet for Combo Building & Solar Permit Application
I Comm'I
City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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FX',Building FR Grading
rDrainage r'Elec rx—Mech
——
r Plum Cu YdCut 98 Cu Yd Fill 180
Project Address (Not mailing address) F_ Flood
r Fire r Liq r; Landslide FN/A Floor Suit_eNo
280 Evening Canyon
V
Description of Work
Use R -3/U Const Type :VB-Spnk
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with a 2 -story pool house
# Stories2 #Units (if Res) 1
(
Valuation $
New/Add SFnor
;1/ ��
Remodel SFGara g a/New/Add 751
1,400,000
Material/Lab
OWNER'S NAME
Last rMendell
First Steven & Carol
Owner's Address
Owner's E-mail Address
80 Evening Canyon
city 10orona del Mar
State CA
Zip 92625 Telephone 949-975-0123
APPLICANT'S NAME
Last ITeale
First Mark
Applicant's Address
Applicant's E-mail Address
900 Bristol St, Bldg A-203
mteale@tealearchitecture.com
City Costa Mesa
State CA
Zip 92626 Telephone 949-975-0123
ARCHITECT/DESIGNER'S NAME Last ITeale First MarkLic. No. C-221I�,
62
Architect/Dasigner's Address
Architect/Designer's E-mail Address
Fme as above
F
City �
State I
—
Zip F_ Telephone
ENGINEER'S NAME
Last Hakim
First Fady Lic. No. C-75736
Engineer's Address
Engineer's E-mail Address
410 Goddard, Suite 200
adyhakim@fmhengineering.com
CityIrvine
State CA
Zip 92618 Telephone 310-422-1536
CONTRACTOR'S NAME/COMPANY
Lic. No. �—', Class
Contractor's Address
Contractor's E-mail Address
City
State I
Zip Telephone
SETBACKS REAR
SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $