HomeMy WebLinkAboutXC2022-2113 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
ix Comm1 I- Residential City of Newport Beach - Building Division T
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
(-Building I- Grading F-Drainage r Elec eMech
F7Plum cuydcutF-- Cu Yd Fill F_
Project Address (Not mailing address) F- Flood r Fire r Liq r Landslide rN/A Floor Suite No
360 San Miguel Dr.
114 405
Description of Work
Use ConstType
I.I.isaciermatologistottice,
is project isT.I. in an existing vacant suite.
inclucling lobby/
rprp to inn avam rnnm5, nffra� I. a�hh,, nnri <torraa\\g�a�y��
# Stories8- # Units (If Res)
�rK/\J,/�
fAft
New/Add SFF RemodelSF� Garage/New/AddF-
Valuation $
Material/Labor 7
OWNER'S NAME Last Rhodes Development Company First
Owner's Address
.Owner's E-mail Address
1401 Avocado Ave, Suite 901
rgraves@rhodesdev.net (Owner's Rep: Rob Graves)
City I Newport Beach State CA
Zip' 92660 Telephone (949) 279-m
APPLICANT'S NAME Last Hsu
First Anthony
Applicant's Address
Applicant's E-mail Address
26961 Camino de Estrella, Suite 200
a@kw-architects.com
City I Capistrano Beach State CA
Zip 92624 Telephone 949-388-1250
ARCHITECT/DESIGNER'S NAME Last Wiggle
First Gary -11042
Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
26961 Camino de Estrella, Suite 200
gary@kw-architects.com
City Capistrano Beach State CA
Zip 92624 Telephone 949-388-1250
ENGINEER'S NAME Last
First F_ Lic. No.F-
Engineers Address
Engineer's E-mail Address
City State F
Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY
{r�
Lic No. Class
Contractor's Address
Contractors E-mail Address
City State F_
Zip F_ Telephone[
SETBACKS REAR SETBACKS FRONT
PERMIT NO. AV YY 'y1
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $