HomeMy WebLinkAboutM2022-0043 - Permit ApplicationPri6t Forip Worksheet for Combo Building & Solar Permit p lication SIR,
r, Comm'I rResidential City of Newport Beach - Building Division ��CO J NOTE: PLAN CHECK FEES DUEATTIME OF SUBMITTAL
jXBBuilding [Grading [Drainage j-Elec [Meth rPlum cuvdcut( cuvdFill F
Project Address (Not mailing address) r Flood rl Fire r', Liq r Landslide rN/A Floor Suite No
4014 Channel Place
of Work Use ConstType
wawa , new concrete zleaman, construct concrete stem wall # Stones; #Units (if Res
f
9 Valuation $
25FOOO
New/Add SFF Remodel SF� Gara a/New/Add F—I Material/Labor
OWNER'S NAME Last IThomas James Homes First
Owner's Address Owner's E-mail Address
26880 Aliso Viejo Parkway, Suite 100
mrosene@tjhusa.com
City Aliso Viejo State CA Zip 92656 Telephone
APPLICANT'S NAME Last
Applicant's Address
26880 Aliso Viejo Parkway, Suite 100
City Aliso Viejo State CA
First jPam
Applicant's E-mail Address
ppullen@tjhusa.com
Zip 92656 Telephone 949-669-3796
ARCHITECT/DESIGNER'S NAME Last First Lic. No. r
Architect/Designer's Address
City State F
Architect/Designer's E-mail Address
Zip ! Telephoned
ENGINEER'S NAME Last (Petrov First Plamen Lic. No. C66947
Engineer's Address
28161 Casitas Ct.
City LFaguna Niguel � State CA
Engineer's E-mail Address
P.Petrov@PMA-BG.com
Zip 92677 Telephone 714-717-7542
CONTRACTOR'S NAME/COMPANY
^ k kLD.�6L LUA�C/L /i / ✓G Lic. No. �477 yL% Class ,
Contractor's Address
city i L-C'o State C'd}
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT
SETBACKS RIGHT
Contractor's E-mail Address
Zip - i— Telephone"
PERMIT NO. R7, u,—
PLAN CHECK NO. 1 f/
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $