HomeMy WebLinkAboutX2012-1631 - Permit ApplicationPrint Form
j— Comm'I Fx— Residential
Worksheet for Building Combo Permit Application saw
City of Newport Beach - Building Division II�J Ill I NOTE: PLAN CHECK FEE DUE AT TIME OF SUALVt
rBuilding rGrading
j—Drainage j`Elec FMech rPlum CuvdCutl CuYdFill F_
Project Address (Not mailing address)
Floor suite No
1014 Polaris Drive
I
Description of Work
Use
Replaring p evicting roncrete
deckwith a new approximately 745 sq feet deck
# StoriesF_e��rii�sjif Res)
concrete
New/AddSFF
Remodel SFr--- Garage/New/Add—
Valuation$ 1g600.00
Material/Labor
OWNER'S NAME
Last Murphy First Robert
Owner's Address
Owners E-mail Address
1014 Polaris Drive
City Newport Beach
State CA Zip 92660 TelephoneF
APPLICANTS NAME
Last Petrov i First Plamen
Applicant's Address
Applicant's E-mail Address
23411 Summerfield #37K
City Aliso Viejo
State CA Zip 92656 Telephone 714-717-7542
ARCHITECT/DESIGNER'S NAME Last -- First [_ Lic. No. F—
Architect/Designers Address
Architect/Designers E-mail Address
City I
State F— Zip f— TelephoneF—
ENGINEER'S NAME
Last Jafari V First Masoud Lic. No. 53812
Engineer's Address
Engineers E-mail Address
25341 Commercentre Drive
Suite 100 m.jafari@wsase.com
City Lake Forest
State CA Zip 92656 Telephone 949-206-9929
CONTRACTOR'S NAME/COMPANY Lic. No. F— Class
Contractors Address
Contractors E-mail Address
City I
State I Zip r Telephone[
ENERGY P/C FEE $
FIRE P/C FEE $ PERMIT NO.
GRADING P/C FEE $
PLANNING P/C % PLAN CHECK NO.
ELEC/PLUM/MECH P/C FEE $
PLAN CHECK FEE $
DEVELOPMENT #
2
JUL 10 2012 TOTAL FEES PAID $ 3
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