HomeMy WebLinkAboutX2022-0016 - Permit Application0 U AIS�0_e�s_k_o S� "Pow
P int Form Worksheet for Combo Building & Solar P 1 tion r Comm'I F Residential City of Newport Beach - Building DivisinNOTE: PLAN CHECK FEES DUE AT TIME OE
j—Building f—Grading r—Drainage r—Elec (—Meth (—Plum Cu Yd cut Cu Yd Fill
Project Address (Not mailing address) F Flood r— Fire r Liq r Landslide F_N/A Floor Suite No
1 �C� V Lu F__ �-
Description of Work
Use F—Const Type F_-
5 6g'—
#Stories #Units (if Res)
_TZ
Iq
Valuation $
Material/Labor
New/Add SFF— Remodel SFF— Garage/New/Add F
OWNER'S NAME Last G Jfirst
J
Owner's Address
Owner's E-mail Address
1 Corporate Plaza Dr. Suite 110 Nanci@nicholsoncompanies.com
city r Newport Beach state CA zip 92660 Telephone 949-756-8393
APPLICANT'S NAME Last Glass First Nanci
Applicant's Address Applicant's E-mail Address
1 Corporate Plaza Dr. Suite 110 Nanci@nicholsoncompanies.com
city Newport Beach state CA zip 92660 Telephone 714-865-4465
ARCHITECT/DESIGNER'S NAME Last SumiCh First Geoff Lic. NoT NSA
ArchitecUDesigner's Address Architect/Designer's E-mail Address
31511 Camino Capistrano, Suite A Geoff@geoffsumichdesign.com
city I San Jan Capistrano state A Zip 6 Telephone 949-496-8991'
ENGINEER'S NAME Last a✓ C� First Lic. No.'71 q _ZZ
Engineer's Address Engineer's E-mail Address
City State I Zip F— Telephoner—
CONTRACTOR'S NAME/COMPANY Nicholson Construction Lic. No. 660295 Class
Contractor's Address Contractor's E-mail Address
1 Corporate Plaza Dr. Suite 110 Nanci@nicholsoncompanies.com
city Newport Beach state FCA ZipF 92660 Telephone 949-756-8393
SETBACKS REAR SETBACKS FRONT PERMIT N0.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. �d l
USE ZONE DEVELOPMENT NO r2 Zn7i 1 --p 2103 PLAN CHECK FEES $