HomeMy WebLinkAboutX2021-1464 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application
r Comm'I r Residential City of Newport Beach -Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL 4443 \- \qm
rBuilding rGrading r-Drainage I-Elec rMech r-Plum CuvdCut s CuYdFill
Project Address (Not mailing address) ( Flood r Fire r Liq r Landslide rN/A Floor Suite No
I —
4801 Surrey Drive
Description of Work
Uses ConstType F
OAM&,�
# Storiess # Units (if Res)F—
Cam, b� ok g' X tl�
New/Add SF Remodel SF Garage/New/Add
Valuation$
Material/Labor
OWNER'S NAME Last 2004 Ouzounian Revocable Trust t
Owner's Address Owner's E-mail Address
1 Cor orate Plaza Dr. Suite 110 Nanci@nicholsoncompanies.com
City I Newport Beach State CA Zip F 92660 Telephone 949-756-8393
APPLICANT'S NAME Last First I PIQ -,j c \
Applicant's Address Applicant's E-mail Address
CC2PQr-;�-_ Q QZl ( - \ 16 fic- '� V I C X� Cd6 �l�o-�v� I LDS :' tyy�
�
City-- �, State C� Zip Telephone �i 4 _GI S-VS
ARCHITECT/DESIGNER'S NAME Last ��p First �Q� Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
RICO tq-\,;cy__ SC' `3L-0 6 A) Su l Z r>1 ro 2JI-'�yTE7e"t f' PC- l Cl UCE • Ccfr'�
City COs—)r�i State CYJ Zip Telephone c �
ENGINEER'S NAME Last N First ��o ` Lic. No.
`
Engineer's Address Engineer's E-mail Address
�-A I C 6c�00/� SIB t \ ciOd
City �� t LJState Zip I Telephone 4 -ay s
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 F—CA Zip F92660 Telephone 949-756-8393
—4
SETBACKS REAR SETBACKS FRONT PERMIT NO. ��NL01%—bi%Lb
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 0*n—U21
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $