HomeMy WebLinkAboutXC2022-1855 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
r Comm'I r- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
MWONQV
4 0
Building F Grading rDrainage VElec WMech
DKPIum Cu Yd cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood
j(Fire F_ Liq r Landslide rN/A Floor Suite No
5 i,
Description of Work
Use - ConstType V-B
SFCOn/(J FLcnR 'TF.✓� I YnPQOVG—MjF>�e
MtVjCAe_ 6FRCE
#Stories #Units (if Res)
Pa
Valuation$ F#1371000New/AddSFr�
Material/Labor
nQ
Remodel SF f`�Garage/New/Add ^/`A
OWNER'S NAME Last Dacorte
First Heather
Owner's Address
Owner's E-mail Address
120 Fifth Avenue, 5th Floor
heather.dacorte@kindbody.com
City New York State NY
Zip 10011 Telephone 707-567-9194
APPLICANT'S NAME Last-rAYLOa
First �RREI'
Applicant's Address
Applicant's E-mail Address
City L(Dc)M State
N �o� QFNf A7ONELc�p1 F-Alr Coy
,�
IS C �9—
Zip 951 0 Telephone ISOSgyp �53�
I.J 65
ARCHBTECT/DESIGNER'S NAME Last u m First EoFF"Q Lic. No.
Architect/Designer'sAddress
Architect/Designer's E-mail(JilAddress
c [c
9 5 PINE AVE-- S7F_ g6o
�`
W Z YY I CA E!`/G-71' FAk� La (f(�m
City + 01V`6 SFAe-�I State �—
[
Zip Telephone 9_06-77�
ENGINEER'S NAME Last I MA7Tl-EW.5
First Tt?LKF1R Lic No. M 40548
Engineer's Address
Engineers E-mail Address
I IS PINF- AVTa 6TE 'aSO
W!-f,IVA=�-XrC�K-4 -.00y
City QState c/7
Zip 90Telephone56a-k6-77a0
CONTRACTOR'S NAME/COMPANY a�A®A�
(t'7U{K7
1ic No.
p-. '7 7 S �j�j 7Class�
Contractor's Address
Contractors E-mail Address
�- /GJ vl G
City LN �`� State
Zip c7 Telephone 7i y , q91 _ /3/
SETBACKSREAR SETBACKS FRONT
PERMIT NO. /-N/QGZ°7-Z ^
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. PC 2QLrL- 1% ? 5
USE ZONE DEVELOPMENT NO -
PLAN CHECK FEES $