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HomeMy WebLinkAboutX2021-1654 - Permit ApplicationPnntForm , ; Wo s eet or Combo Building & Solar Permit Application (— Comm'I (X Residentia X City of Newport Beach - Building Division - NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL rBuilding Grad in Drainageec ech Plum curdCut s, cuvdFilis x -- Project Address (Not mailing address) r Flood r Fire F Liq r Landslide 17N/A Floor Suite No 513 CATALINA DRIVE. F�' - -...--....._ . Description of Work Use R3/U ConstType VB CONVERSION OF A PERMITTED 400-SO AR -FOOT RECREATION ROOM INTO AN ACCESSORY # Stories # Units (if Res) s DWELLING UNIT (ADU). Valuation $ Material/Lab � New/AddSFIV Remodel SF400 Garage/New/Add 363" OWNER'S NAME Last LANGE First TONY Owner's Address Owner's E-mail Address 513 CATALINA PRIVE ticnpt@sbcglobal.net City NEWPORT BEACH _ State CA Zip 92663 Telephone (949) 422-1165 APPLICANT'S NAME Last LANGE First TONY Applicant's Address Applicant's E-mail Address 513 CATALINA DRIVE ticnpt@sbcglobal.net City NEWPORT BEACH State CA Zip 92663 Telephone (949) 422 1165 ARCHITECT/DESIGNER'S NAME Last BENSON _ First JEFFREY Lic. No. C3226B Architect/Designer's Address Architect/Designees E-mail Address 234 BROADWAY JB@BDANDARCH.COMI City COSTA MESA State CA Zip 92627 Telephone (949) 534 2724 ENGINEER'S NAME Last N/A First F®', Lic No.F_ Engineer's Address Engineer's E-mail Address City State F ------- Zip �! Telephone CONTRACTOR'S NAME/COMPANY N/A Lic. No. F Class Contractor's Address Contractor's E-mail Address I W 1L4a - _ ._ _._.....-. City State �— Zip [77777�7 Telephoned n- s SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $