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HomeMy WebLinkAboutX2021-0135 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application &SUBMITTAL Comm'I OZ Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE ATTIME OF F. ow+ DZBuilding PZGrading GZDrainage DZElec DZ Mech GZplum CuvdCut 72 CuvdFill 140 Project Address (Not mailing address) PZ Flood r Fire [Z Liq r Landslide rN/A Floor Suite No 16 SAPPHIRE AVENUE, BALBOA ISLAND�— Description of Work Use FR Contt Type B-NR Demolish Existing Dwelling. Construct New Three -Story, Single -Family Dwelling with Attached # Storiesl3 # Units (if Resf 1 Valuation $F$520'000.00 New/Add 5 Remodel Ga dd ,IJMaterial/Labor OWNER'S NAME Last Perry First Daniel Owner's Address - - Owner's E-mail Address 26073 Shadow Rock Lane �perry@riversidecompany.com. City Valencia State CA Zip 1381 Telephone 818-749-4139 APPLICANT'S NAME Last Architect First Applicant's Address Applicant's E-mail Address City _ State r Zlp F_____— TelephoneFs ARCHITECT/DESIGNER'S NAME Last Harriso _ First Ian Lic. No. C-6947 Architect/Designer's Address Architect/Designer's E-mail Address 220 Newport Center Drive, Suite 11-342 Ian@lanHarrisonArchitect.com - City Newport Beach State CA Zip r92660 Telephone 949-723-1091 GINEER'S NAME Last Gabriel First Michael Lic No. s-2939 Engineer's Address Engineer's E-mail Address 483 East 20th Street mrgse@earthlink,net City Costa Mesa State CA Zip 92627 Telephone 949-646-6596 CONTRACTOR'S NAME/COMPANY Lic. No. F— Class Contractor's Address Contractor's E-mail Address city State F_ Zip Telephoned SETBACKS REAR SETBACKS FRONT PERMIT NO.Xi,514- 0135 X IA2I-013b SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO 1 ^ PLAN CHECK FEES $