HomeMy WebLinkAboutX2022-1272 - Permit Application (3)Print Form Worksheet for Combo Building & Solar Permit Application 0b.'§WW1qRNComm'I r, Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
FXBuilding r— Grading rDrainage r Elec [Xj Mech R. Plum Cu vd Cut F_ cuvd Fill F
Project Address (Not mailing address) rkFIood r, Fire r Liq r Landslide ❑N/A Floor Suite No
1106 Amethyst
Description of Work
Use SFR ConstType u8
Demo rebuild kitchen, demo rebuild 6 bathrooms, demo rebuild interior walls, new doors and
WiRdews'deme
# StoriesF2 —1 #Units (if Res)I 7 ;
penen of Foof and expARd
Valuation $
Material/Labor 20,699
New/Add SF7 Remodel SF 3866 Garage/New/Add �'
OWNER'S NAME Last Russell J First ohn
Owner's Address Owner's E-mail Address
106 Amethyst
City Newport Beach State Ca. Zip 92662' Telephone 949-265-2640
APPLICANT'S NAME Last Lushbaugh First Filliarn
Applicant's Address Applicant's E-mail Address
17191 Citron blushbaugh@aol.com
City Irvine I State Ca. Zip 92612 Telephone 949-584-2166
ARCHITECT/DESIGNER'S NAME Last Lushbaugh First illiam Lic. No. 24867
Architect/Designees Address Architect/Designer's E-mail Address
17191 Citron blushbaugh@aol.com
City Irvine State Ca. Zip 92612 Telephone 949-584-2166
ENGINEER'S NAME Last Jamil First Bashar Lic. No. P83129
Engineer's Address Engineer's E-mail Address
Shasta �j
City Corona State Ca. - Zip 92881 Telephone 714-883-4214 �
city
CONTRACTOR'S NAME/COMPANY �v j t ��,�� I_ � �5 Lic. No. �3J s-70 Class
Contractor's Address Contractor's E-mail Address
City State Zip Telephone ��� L U V 5^2ps'
SETBACKS REAR SETBACKS FRONT PERMIT NO. XW2,2 11�y
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. �I��j •JAZZ
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $