HomeMy WebLinkAboutX2021-3300 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
ial City of Newport Beach - Building Division NOTE: PLAN HECK FEES DUE AT TIME OF SUBMITTAL Z� O
trading f7Drainage Mlec
mailing
n of Work
.-II IV ---u PdL]V cover.
(, Mech f-Plum cu
Flood I-; Fire rl Liq f-, Landslide
New/Add SF 255 Remodel SF�—'
-.- - Garage/New/Add
OWNER'S NAME
Last Pietsch TPR F0.wt LLCJ -
First Michael
Owner's Address - �------------ -
20 Colonial Owner's E-mail Address
I
City Newport Beach --
State C
Zia 92660
._ PTelanhn�
Cu Yd Fill I
❑N/A Floor Suite No
_i Ij F'
Use R3 ConstType B
Y Stories # Units (if Res)r 1
raluation $
Aaterial/Labor 25,000
)49-466-3919
r.rru�ruv r---� NAME _-
Last Lm
ushbaugh First Illia
Applicant's Address 17191 Citron - - - - - - - -
Applicant's E-mail Address
- - - - - blushbaugh@aol.com
City Irvine -
State Ca.
- Telephone 949-584 2166
ARCHITECT/DESIGNER'S NAME
Last
Lishbaugh Zip 2612 First illiam i
- Lic. No.
- C24867 Architect/Designer's Address -- -
17191 Citron Architect/Designer's E-mail Address
blushbaugh@aol.com
City Irvine Ica
�— -
State Ca. Zip 92612 Telephone 949-584-2166
i
ENGINEER'S NAME Last Jamil
First Bashar ' Lic. No. C83129
Engineer's Address
75 Shasta Engineer's E-mail Address
basharJl@twc.com
City Corona - --.
State Ca. - -
- _ Zip 92881 Telephone 714-883-4214-4214
CONTRACTOR'S NAME/COMPANY
Contractor's Address
City State
I SETBACKS REAR
I SETBACKS LEFT
I USE ZONE
SETBACKS FRONT
SETBACKS RIGHT
Lic. No. r Class
Contractor's E-mail Address
Zip Telephone
DEVELOPMENT NO TL02-l'
PERMIT NO. A\9.02(33("
PLAN CHECK NO. Zabp' ? t7yl
PAN CHECK FEES $ �1 Zcj_ Z3