HomeMy WebLinkAboutM2021-0015 - Permit Applicatione�r�ntFort�;r� Worksheet for
Comm'I 17� Resid
WA
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7 � NOTE:
Combo Building & Solar Permit Application
City of Newport Beach - Building Division
PLAN CHECK FEES DUE AT TIME OF SUBMITTAI
A./ ilding Grading rDrainage r'Elec rMech Plum Cu Yd Cut Cu Yd Fill
11
Project Address (Not mailing address) 1- Flood r Fir r Liq r: Landslide rN/A Floor Suite No
Description of Work
Use A Const Type A—
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I� tib I r 4 #Stories #Units (if Res)
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New/Add SF Remodel SF
Valuation a /� I D�
Garage/New/Add �— Material/Labor L }I
OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
�LY—
jut�04 dU-ijt)nNt71"DrGorrlPam) - coIm
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City N-60In t Ir a( Stater Zip (�— Telephone p�LFj _ �j 1
APPLICANT'S NAME Last MORALES
First I MARISSA
Applicant's Address
Applicant's E-mail Address
6351 INDUSTRY WAY
MARISSA@SWIFTSLIPDOCKS.COM
City WESTMINSTER StateCA
Zip 92683 Telephone 949-631-3121
ARCHITF,1CT/DESIGNER'S NAME Last FirstLic. No.
- -
Architect/Designer's Address
ArchitecUDesigner's E-mail Address
City State F
Zip I Telephonel—
ENGINEER'S NAME Last PETROVFirst
PLAMEN Lic. No.66947
Engineer's Address
Engineer's E-mail Address
28191 CASITAS COURT
P.PETROV@PMA-BG.COM
City LAGUNA NIGUEL StateCA
Zip 92677 Telephone 714-717-7542
CONTRACTOR'S NAME/COMPANY SWIFT SLIP DOCK & PIER BUILDERS, INC Lic. No. 797052 ClasslA
Contractor's Address
Contractor's E-mail Address
6351 INDUSTRY WAY
MARISSA@SWIFTSLIPDOCKS.COM
City WESTMINSTER State CA
Zip 92683 Telephone 949-631-3121
SETBACKS REAR SETBACKS FRONT
PERMIT NO. N�L�/ �l — C)U ) 6J
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. QN� i .- T 177,(
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $