HomeMy WebLinkAboutXR2022-3301 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division
Comm'I R Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL +"
F Building PZ Grading
DZDrainage 5Z Elec OZ Mech OZ Plum Cu Yd cut 72 Cu Yd Fill 140
Project Address (Not mailing address) I— Flood I— Fire I— Liq r Landslide rN/A Floor Suite No
208 Collins Avenue, Balboa Island
I
Description of Work
a SFD ConstType V-B
Demo Existing Dwelling and Garage. Construct New Three -Story Dwelling with a Junior
# StoriesF3 # Units (if Res)2
Property Line Concrete Block
Walls (160 Linear Feet).
Valuation $
New/Add SF F2,39320
Remodel SF Garage/New/Add F396.61
Material/Labor [S520,000.00
OWNER'S NAME
Last Rose First David
Owner's Address
Owner's E-mail Address
318 Amethyst Avenue
david@melroseind.com
City I Newport Beach
State CA Zip 92662 Telephone 760-574-7513
APPLICANT'S NAME
Last Architect First
Applicant's Address
Applicant's E-mail Address
City
State F___ Zip F__ Telephoned
ARCHITECT/DESIGNER'S NAME Last Harrison First Ian Lic. No. C-6947
Architect/Designer's Address
Architect/Designer's E-mail Address
220 Newport Center Drive,
#11-342 Ian@IanHarrisonArchitect.com
City Newport Beach
Zipn@IanHarrisonArchitect.com
State 92660 Telephone 949-887-4534
ENGINEER'S NAME
Last Rezaei First Ali Lic. No. 41068
Engineer's Address
Engineer's E-mail Address
18021 Sky Park Circle, Suite
E2 ali@rce-eng.com
City Irvine
State CA Zip 92614 Telephone 949-466-9394
CONTRACTOR'S NAME/COMPANY Lic. No. �— Class
Contractor's Address
Contractor's E-mail Address
City
State I— Zip Telephoned
Y
SETBACKS REAR
SETBACKS FRONT PERMIT NO. t�pZi/ �� V I
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. %
USE ZONE
p+�',,
DEVELOPMENT NO '`qZ0' Z-b2Q> PLAN CHECK FEES $
Print Form J Worksheet for Combo Building & Solar Permit Application
r Comnn1 Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F_ Building F_Grading rDrainage F_Elec F_Mech rPlum CuvdCut CuYdFill
�
Project Address (Not mailing address) r Flood F_ Fire r Liq F_ Landslide rN/A Floor Suite No
2o(� (,, 1J 3 c N C,,-w.2 F- F
Description of Work
Use F—ConstType F_
# StoriesF #Units (if Res)
�)/
New/AddSFF Remodel SFF— Garage/New/Add
Valuation $_
Material/Labori`'
OWNER'S NAME Last
�R \`e"1 `, First
ll
Owners Address
Owner's E-mail
l� 0 o-n A, ,to
�L CL—,C% [Address
P_ cc, S2 '1 e1
City ¢.�(��� pu-t
v
C IM
State �q-L — Zip (e 2 Telephone 7 (10 - 51,( - -1 S 1'3
APPLICANT'S NAME Last
_Z rv}t r_ \ a
`• S 7vMFirst ��j -. ` J�Qrs
Applicant's Address
Applicant's E-mail Address
2 \ o M&r� A.2
I Cp^.
City Q ,_ ,
State CP Zip 9 2-" Z Telephone qM � b 4k- g 9 u o
ARCHITECT/DESIGNER'S NAME
`'
Last n0.r f s c+\ First 1 411\ Lic. No. �—
ArchitectiDesigner's Address
Architect/Designer's Address
11E-mail
14^ (Lk a '^ Y%C�(!. {G�l ctCe..N�6��T .GSM
City
State F— Zip F_ Telephone q�4 - 8 8 -r- u S 3 9
ENGINEER'S NAME Last First F_ Lic. No.F_
Engineer's Address
Engineer's E-mail Address
City I
State F Zip F— Telephoned—
CONTRACTOR'SNAMElCOMPANY \,/h^IVCIe n C�)�►M i`, ;`i;No. 4Z t4j`{Class
\
Contractor's Address
Contractor's E-mail Address
City 13 �� p �t��.��
State C pt Zip � L% �+ Z Telephone q A y_ to (A q — g- q o I
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES `;