HomeMy WebLinkAboutXC2023-0349 - Permit Application%rintForm Worksheet for Combo Building & Solar Permit Application
Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[_Building [_Grading F—Drainage rElec rx—Mech [_"Plum Cu vd Cut cu Yd Fill
Project Address (Not mailing address) r- Flood F- Fire r Liq r Landslide FN/AFFloor
510 Superior Ave Newport Beach, CA 92663 I'
Suite No
Use I Const Type f
# Stories # Units (if Res)l
Valuation $
New/AddSFF_ Remodel SF409 Garage/New/Add Material/Labor
OWNER'S NAME Last IQUIRAM First JBILL
Owner's Address Owner's E-mail Address
ONE HOAG DRIVE bill.quiram@hoag.org
City NEWPORT BEACH State CA Zip 92663 TelephoneF
APPLICANT'S NAME Last ILIEBKE First ISTEVE
Applicant's Address Applicant's E-mail Address
1340 REYNOLDS AVE SUITE 115 sliebke@liebke.org
City IRVINE State CA Zip 92614 Telephone 949-752-5052
ARCHITECT/DESIGNER'S NAME Last LIEBKE First STEVE Lic. No. C-28341
Architect/Designer's Address ArchitecUDesigner's E-mail Address
1340 REYNOLDS AVE SUITE 115 sliebke@liebke.org
City IRVINE State CA Zip 92614 Telephone 949-752-5052
ENGINEER'S NAME Last STEPHEN First PiICEK Lic. No. E 10372
Engineer's Address Engineer's E-mail Address
150 PAULARINO AVE. SUITE A120 stevez@fbaengr.com
City COSTA MESA State CA Zip 92626 Telephone (949) 852-9995
CONTRACTOR'S NAME/COMPANY
Contractor's Address
City
SETBACKS REAR
SETBACKSLEFT
Lic. No. F_ Class
Contractor's E-mail Address
State Zip Telephone
SETBACKS FRONT
SETBACKS RIGHT
PERMITNO.
PLAN CHECK NO.PCZEL14
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $