HomeMy WebLinkAboutX2021-2102 - Permit Applicationnt Form Worksheet for Combo Building & Solar Permit Application (Fd
pg�
City of Newport Beach- Building Division g
Comm'I IS Residential d
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
15 Building 17 Grading
D(Drainage FElec rMech 17 Plum Cu Yd Cut l v Cu Yd Fill FJ
Project Address (Not mailing address) r- Flood r Fire r Liq r Landslide r—N/A Floor V Suite No
430 Tustin Avenue
5 F
Description of Work
UseR 3/U Const Type V6
27 story single a l y sl ence
wl ce garage, a rooms, a s,
home office, front porch 225
s . ft.(3 afire
# Stories # Units (if Res)s
New/Add 4,271
Remodel SFF__ Ga age/New/A d 759
Valuation $
Material/Labor �� K
OWNER'S NAME
Last 430 Tustin LLC First
Owner's Address
Owner's E-mail Address
790 Newton Way
sepulvedabuildersinc@gmail.com
City Costa Mesa
State Ca. Zip 92627 Telephone 714-288-0732
APPLICANT'S NAME
Last Sepulveda First Fz"
Applicant's Address
Applicant's E-mail Address
790 Newton Way
sepulvedabuildersinc@gmail.com
C ty Costa Mesa
State Ca. Zip 92627 Telephone 714-288-0732
ARCHITECT/DESIGNER'S NAME Last Oslin First FErian I
Lic. No.
Architect/Designers Address
Architect/Designer's E-mail Address
8621 Bellmead Drive
oslin.design@gamil.com
City Huntington Beach
State Ca. Zip 92646 Telephone 714-962-1148
ENGINEER'S NAME
Last Rohrer First Faul Lic. No. 4340 (SE)
Engineer's Address
Engineers E-mail Address
17291 Irvine Avenue
Paul@PRSEInc.com
City Tustin
State Ca. Zip 92780 Telephone 714-486-2537
CONTRACTOR'S NAME/COMPANY +Sepulveda Builders, Inc. Lic. No. 695401 Class B1
Contractors Address
Contractors E-mail Address
790 Newton Way
sepulvedabuildersinc@gmail.com
City Costa Mesa
State Ca. Zip 92627 Telephone 714-288-0732
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO 0 PLAN CHECK FEES $
Print Form Worksheet for Combo Building & Solar Permit Application
r Comm'] Residential City of Newport Beach - Building Division o
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
KBuilding RGrading RDrainage RElec RMech
5(Plum Cu Yd CutF Cu Yd Fill
Project Address (Not mailing address) f Flood
F_ Fire r— Liq r Landslide FN/A Floor Suite No
430 Tustin Avenue
Description of Work
Use R3/1J Const Type VB
2--story single ramily resl ence witn attacnea 3-car garage, 4
Dearoorl"IS, 4 1/2 batris,
home office, front porch 225 s . ft.), 3 gas fireplaces
# StoriesF # Units (if Res)F
Valuation
New/Add SF 4,271 Remodel SF F— Garage/New/Add 759
�L
Material/Labor r
OWNER'S NAME Last 430 Tustin LLC
First
Owner's Address
Owner's E-mail Address
790 Newton Way
sepulvedabuildersinc@gmail.com
City Costa Mesa State Ca.
Zip 92627 Telephone 714-288-0732
APPLICANT'S NAME Last Sepulveda..
First I �jM ,
Applicant's Address
Applicant's E-mail Address
790 Newton Way .
sepulvedabuildersinc@gmail.com
City Costa Mesa State Ca.
Zip 92627 Telephone 714-288-0732
ARCHITECT/DESIGNER'S NAME Last 0slin First Brian Lic. No.
Architect/Designer's Address
Architect/Designers E-mail Address
8621 Bellmead Drive
oslin.design@gamil.com
City Huntington Beach State Ca.
Zip 92646 Telephone 714-962-1148
ENGINEER'S NAME Last Rohrer First Paul Lic. No.4340 (SE)
Engineers Address
Engineer's E-mail Address
17291 Irvine Avenue
Paul@PRSEInc.com
City Tustin State Ca.
Zip 92780 Telephone 714-486-2537
CONTRACTOR'S NAME/COMPANY Sepulveda Builders, Inc. Lic. No. 695401 Class Bi
Contractors Address
Contractors E-mail Address
790 Newton Way
sepulvedabuildersinc@gmail.com
City Costa Mesa State Ca.
Zip 92627 Telephone 714-288-0732
SETBACKS REAR 5 SETBACKS FRONT 10 PERMIT NO. 74 t
SETBACKS LEFT � SETBACKS RIGHT
y PLAN CHECK NO. I
USE ZONE R-` DEVELOPMENT NO
PLAN CHECK FEES $