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HomeMy WebLinkAboutM2019-0021 - Permit Application (2)Mme« -o07--1 Print Form_ Worksheet for Combo Building & Solar Permit Application now r Comm'I r" Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL (Building (Grading (Drainage ("Flet f—Mach(-PlumCu Yd Cut ulTd€I DIVISION ITYOFM#PORT BEACH Project Address (Not mailing address) r Flood r' Fire r- Liq r- Landslide I -N7 Flo r Suite o Description of Work ------- __ - -- -- Use F_ Const Type r �� ' ` V�1 I Oyvl 1 vq if Stories- # Units (If Res)F_ Valuation $ 1 Materlal/Labor New/Add SFF Remodel SF�— Garage/New/Add �— OWNER'S NAME Last First Owner's Address Owner's E-mail Address �� LI JI A-MY1 1 (j City G State I ` Zip 2 Telephone 10 • 20 APPLICANT'S NAME Last CHUNG First ACQUELYN Applicant's Address Applicant's E-mail Address 351 INDUSTRY WAY ACQUELYN.CHUNG@SBCGLOBAL.NET City ESTMINSTER State CALIFORI` Zip 92683 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 I Zip r TelephoneF ENGINEER'S NAME Last PETROV First PLAMEN Lic. No. 6947 Engineer's Address Engineer's E-mail Address 8191 CASITAS COURT IP.PETROV@PMA-BG.COM City LAGUNA NIGUEL State CALIFOR� Zip 92677 Telephone 714.717.7542 CONTRACTOR'S NAME/COMPANY SWIFT SLIP DOCK AND PIER BUILDERS, INC. Lic. No. 797052 Class Contractor's Address Contractor's E-mail Address 6351 INDUSTRY WAY ACQUELYN.CHUNG@SBCGLOBAL.NET City ESTMINSTER State FORK Zip 2683 Telephone 949.631.3121 SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. s, •fir' USEZONE DEVELOPMENT NO PLAN CHECK FEES$ /it<