HomeMy WebLinkAboutM2019-0023 - Permit ApplicationM 1,0 �ci-Co2z,
Print Form Worksheet for Combo Building & Solar Permit Application
F' Comm'1 (' Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMI
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r -Building F— Grading r—Drainage j— Elec r Mech r Plum cu Yd cut �� ppCuY��d FII pp M 11I
Project Address (Not mailing address) Flood (— Fire r— Liq F— Landsl'idE UI►�ORIdorER"SUit� No
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Description of Work pp !r IA t �f, Use Const Type
�J , # StoriesF # Units (if Res)
LA � s+ li ��5 Ff��j �i."-�"i4.t` �P / .rte -
' i� t..k i1��ts��s
(�ry%'e� ' 1 = � • Valuation $ 117,
' VN W r�di S j Red�el SF Garage/New/Add �Material/Laborl/ DD
OWNER'S NAME Last U i� j First 'JA
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Owner's Address Owner's E-mail Address
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City N—ew- ba ^Jl O >� State I C -A Zip / Telephoned
APPLICANT'S NAME Last CHUNG First PACQUELYN
Applicants Address Applicant's E-mail Address
351 INDUSTRY WAY JACQUELYN.CHUNG@SBCGLOBAL.NET
city State CALIFORD Zip 92683 Telephone 49.631.3121
ARCHITECT/DESIGNER'S NAME Last First �— Lic. No. �—
Architec fDesigner's Address Architect/Designer's E-mail Address - -
City State �— Zip I TelephoneF——
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
Ciry LAGUNA NIGUEL State CALIFORZip 92677 Telephone714.717.7542
CONTRACTORS NAME/COMPANYWIFT SLIP DOCK AND PIER BUILDERS, INC. Lic. No. F97052 ClassC'
Contractor's Address Contractor's E-mail Address _
351 INDUSTRY WAY ACQUELYN.CHUNG@SBCGLOBAL.NET
City FESTIVINSTER State FALIFORN Zip 2683 Telephone 949.631.3121
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
71
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