HomeMy WebLinkAboutX2020-2267 - Permit ApplicationA ° Z+ (o --
Worksheet for Building Combo Permit Application
City of Newport Beach - Building Division o
r Comm'I �, Residential NOTE: PLAN CHECK FEE DUE AT TIME OF SUBMITTAL
U0.Ms
rBuilding r– Grading rDrainage rElec F_ Mach r; Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address)
F�loor� Suite No
27 1. St. Tropez
j
ZT 731 i
Description of Work
Use lei
PaP4ohed hprp
N � el�tgf�a'
ah�l
# Stories # Units (if Res)
Valuation $ U
- -
New/Add SF 6G Remodel SFFZ.9Z
Garage/New/Add
Material/labor hr
OWNER'S NAME Last I
V,4Q1
First JQN
Owner's Address
Owner's E-mail Address
9-1 -?f• %%OPG
✓1/GIah�G'SbLylO�ia Me -7
City /vG!ge-f/ ' Ra
State CA, Zip F Telephone
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
1#6-8 A11,064 -Pe
V4&.47*eillyho&e-s aGOK .
City I Gli�AA,651l7A=5_
State I �
Zip .. �zfJ,��-"� Telephone m-8✓�
ARCHITECT/DESIGNER'S NAME
Last
First F_F_
Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State ,
Zip, Telephone—
ENGINEER'S NAME Last
�jUppdy� t'.
First /''j,�e.... Lic. No. 5,435
Engineer's Address/
Engineer's E-mail Address
$975 BdSe,JESS��IRK AV,5l Swat
City.
State I "P
Zip ?Z TelephoneINIkeC�(rytrjQe(/1i1, Gpyy%
CONTRACTOR'S NAME/COMPANY
Lic. No. � C✓✓lass f .0
Cohs�cfrey 357 9 d�7
Contractor's Address
Contractor's E-mail Address
(
1 X13 AVoa
�tLP� l�olnesG cosc•het
City 54ei /b`c
State �G
Zip �ZFJS�', Telephone 710 31D,4 $
ENERGY P/C FEE $
FIRE P/C FEE $
PERMIT N0.
GRADING P/C FEE $
PLANNING P/C FEE $
PLAN CHECK NO. r
ELEC/PLUM/MECH P/C FEE $
PLAN CHECK FEE $
DEVELOPMENT#
TOTAL FEES PAID $