HomeMy WebLinkAboutXR2023-0044 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application (F.,4§0Comm'I �C' Residential City of Newport Beach -Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
JX'.Building [Grading
f--Drainage f—Elec r_Mech rPlum cuYdcut F cuYdFillF_
Project Address (Not mailing address) r Flood r Fire r Liq (- Landslide rN/A Floor Suite No
ST
3109 CLAY
Description of Work
Use F—ConstType F_
NEW SFR/GARAGE 5704/564 SF. DETACHED A.D.U. 898 SF
# Stories[— # Units (if Res)[ —
Valuation $
New/Add SFF
Remodel SFF— Garage/New/Add I
F116,000
Material/Labor
OWNER'S NAME
Last FBELL FAMILY TRUST First
Owner's Address
Owner's E-mail Address
77 THAYNES CANYON DR
DANIELLE@SWEATPANTSIEDIA.COM
City PARK CITY,
State OFT Zip 84060 Telephone (562) 436-5200
APPLICANT'S NAME
Last VAN DIJS First JAN
Applicant's Address
Applicant's E-mail Address
380 JUNIPERO AV
JAN@JRVANDIJS.COM
City LONG BEACH
State CA Zip F90814 Telephone (562) 832-2499
ARCHITECT/DESIGNER'S NAME Last VAN DIJS First PAN _.._ Lic. No.
Architect/Designer's Address
Arch itect/Designer's E-mail Address
380 JUNIPERO AV
JAN@JRVANDIJS.COM
City LONG BEACH
State CA Zip F90814 Telephone (562) 832-2499
ENGtNEER'S NAME
Last GARZA _ First MMAR Lic. No.F—
Engineer's Adamss
Engineer's E-mail Address
600 WILSHIRE B'.VD Uni':
860
City _ LOS ANGELES
State CA Zip I90017 Telephone (213) 627-6687
CONTRACTOR'S NAME/COMPANY Lic No. �6,C,C3 Class '
Contractor's Address
Contractor's E-mail Address
City F---
State F Zip F_ Telephoned—
SETBACKS REAR
,1
SETBACKS FRONT PERMIT NO. X O —14
1
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $