HomeMy WebLinkAboutM2021-0036 - Permit ApplicationTV[ r2_0,2_1 -U 03 b `fo I I C,�Ctvllle 1 SPI
Worksheet for Combo Building & Solar Permit Application
r,uComm'I r Residential City of Newport Beach -Building Divisi(rr UBLIV WORKS o r f
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
g_Building [ Grading F. -Drainage r, Elec rMech r Plum Cu yd u Fii
Project Address (Not mailing address) 1- Flood r Fire r('L}4LOPi(NBW)PMT B�r�j
4017 CHANNEL PLACE
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Description of Work
Use Const Type
REMOVE AND REPLACE EXISTING FLOATING DOCK LIKE FOR LIKE- NO CHANGIF IN r17F OR
#Stories; #Units (if Res)'
DIMENSIONS. EXISTING CONCRETE PILE, PIER AND GAGNWAYTO
REMIAN.
Valuation $
New/Add SF�—, Remodel SFF
Garage/New/Add �,
81900 900
Material/Labor'
OWNER'S NAME Last BLLACKMON
First JEFF
Owner's Address
Owner's E-mail Address
4017 CHANNEL PLACE
JBLACKMON@BLACKMONHOMES.COM
City NEWPORT BEACH State CA Zip 92663 Telephone F949-631-3121
APPLICANT'S NAME Last MORALES
First MARISSA
Applicant's Address
Applicant's E-mail Address
6351 INDUSTRY WAY
MARISSA@SWIFTSLIPDOCKS.COM
City WESTMINSTER State CA
Zip 92683 Telephone 949-631-3121
ARCHITECT/DESIGNER'S NAME Last First F Lic. No.
Architect/Designees Address
Architect/Designer's E-mail Address
City _. State �'.
Zip [__7 Telephone-
ENGINEER'S NAME Last PETROV
FirstPLAMEN Lic. No.66947
Engineer's Address
Engineer's E-mail Address
28191 CASITAS COURT
P.PETROV@PMA-BG.COM
City LAGUNA NIGUEL State [CA77
Zip92677 Telephone 714-717-7542
CONTRACTOR'S NAME/COMPANY SWIFT SLIP DOCK & PIER BUILDERS, INC Lic. No. 797052 Class
Contractor's Address
Contractor's E-mail Address
6351 INDUSTRY WAY
MARISSA@SWIFTSLIPDOCKS.COM
City WESTMINSTER StateCA
Zip 92683 Telephone 949-631-3121
SETBACKS REAR SETBACKS FRONT
PERMIT NO..S6
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $