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HomeMy WebLinkAboutX2022-0766 - Permit Application12P" Form ; > y Worksheet for Combo Building & Solar Permit Application Comm'I al rl ResidX'Zp �y – 766 City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL [Building ❑Grading rDrainage F_ Flet Project Address (Not mailing addrea 325 COLLINS AVE F_'Mech ❑ Plum cu Yd rl Flood r Fire i) Liq [—I Landslide Description of Work MFR (N) WINDOWS & RELOCATE DOOR, ENCLOSE DECKTO LAUNDRY RM (63 SF) *STOPWORK �z�2gg* J New/Add SFF ___ 7—I Remodel SF 63 l Garage/New/Add Cu Yd Fill F—�N/A Floor Suite No UseF7 ConstType� # StoriesF7 # Units (if Res) Valuation $ [17500 Material/Labor — OWNER'S NAME Last BENDETTI First ROBERT &MICHELLE Owner's Address Owner's E-mail Address 25 COLLINS AVE City NEWPORT BEACH State F_77 Zip Telephoned APPLICANT'S NAME Last First Applicant's Address Applicant's E-mail Address PO BOX 11658 City NEWPORT BEACH State Zip Telephone949-246-4085 ARCHITECT/DESIGNER'S NAME Last ALKERFirst BARRY Lic. No. 19637 Architect/Designer's Address Architect/Designer's E-mail Address City �— State F77 Zip �J Telephoned ENGINEER'S NAME Last REZAEI First [FL I Lic. No. C-41068 Engineer's Address Engineer's E-mail Address I 1 City State Zip Telephone 949-466-9394 _--------- -___ CONTRACTOR'S NAME/COMPANY Lic. No. F Class Contractor's Address Contractor's E-mail Address City State F Zip F Telephoned SETBACKS REAR SETBACKS FRONT SETBACKS LEFT SETBACKS RIGHT PERMIT NO. PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $