HomeMy WebLinkAboutM2019-0021 - Permit ApplicationMf�o�G-o07--1
Print Fonn Worksheet for Combo Building & Solar Permit Application a? ,
r Comm'I i— Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL cu...+
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Description of Work
Use F Const Type
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1 1 ' V-A ` I� V
# Stories # Units (If Res)F—
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Valuation
Material/Laa bor
New/Add SF�— Remodel SF� Garage/New/Add �—
OWNER'S NAME Last First
Owner's Address Owner's E-mail Address
Iz 6/ I�
Ci ty State d �}
I I � i'� Zip Z Telephone 10 , 2 ! , OS 15
APPLICANT'S NAME Last CHUNG First ACQUELYN
Applicant's Address Applicant's E-mail Address
351 INDUSTRY WAY ACQUELYN.CHUNG@SBCGLOBAL.NET
City PESTMINSTER State CALIFORN Zip F2683 Telephone 49.631.3121
ARCHITECT/DESIGNER'S NAME Last First I — Lic. No. �—
Architect/Designer's Address Architect/Designer's E-mail Address
City �— State �— Zip I TaiephoneF
ENGINEER'S NAME Last PETROV First PLAMEN Lic. No. 6947
Engineer's Address Engineer's E-mail Address
8191 CASITAS COURT P.PETROV@PMA-BG.COM
City LAGUNA NIGUEL State CALIFORN Zip F2677 Telephone 14.717.7542
CONTRACTOR'S NAME/COMPANYSWIFT SLIP DOCK AND PIER BUILDERS, INC. Lic. No. 97052 Classf'
Contractor's Address Contractor's E-mail Address
6351 INDUSTRY WAY ACQUELYN.CHUNG@SBCGLOBAL.NET
City ESTMINSTER State ALIFORN Zip 2683 Telephone F949.631.3121
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SETBACKS REAR SETBACKS FRONT PERMIT NO. fJ Nl -
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
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