HomeMy WebLinkAboutX2020-2968 - Permit ApplicationPrint Form Workshe/et for Combo Building & Solar Permit Application o4 `yoo",
F_ Comm F_ Residentiading Division
l � j� _OTE: PLAty of N Newport LAN CHE KDUEFEES E AT BuiIT rQF.SUBMITTAL V
F- Building [Grading rDrainage Elec rMech F- PI cued y CuvdFill
Project Address (Not mailing address) C Flood r ire Lq F- Landslide s '_ Floor Suite No
320 COLLINS AVE - BALBOA ISLAND
IV
Description of Work
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l7sV IIt_ ConstTYP e VB
RF-ROOF - REPAIR & REPLACE EXISTING ROOF IN PI ACE NEW PROTECTIVE
MEMBRANE AT ROOF
4t Stories It Units (if Res)
DECK, REPAIR MASTER SHOWER WALL FINISHES. NO FOOTAGE
OR STRUCTURAL CHANGES
Valuation $
New/Add SF�— Remodel SF��_—
�
Garage/New/Add lu —
40,000
Material/Labor
OWNER'S NAME Last McDOUGAL
First WESLEY 6V5,0_
Owner's Address
Owner's E-mail Address (f
320 COLLINS AVE
WMCDOUGAL@FIRSTDIGITAL.COM
APPLICANT'S NAME Last ALI
First SAMSAMI
Applicant's Address
Applicant's E-mail Address
28527 KLONDIKE DRIVE
ADG.ARCH.00@GMAIL.COM
City TRABUCO CANYON State CA
Zip 92679 Telephone 949-307-2676
ARCHITECT/DESIGNER'S NAME Last ALI First FsAMSAMI Lic. No.
Arch itecUDesigner's Address
Arch itect/Designer's E-mail Address
28527 KLONDIKE DRIVE
ADIS ARCH.00@GMAIL.COM
City TRABUCO CANYON State CA
Zip 92679 Telephone 949-307-2676
ENGINEER'S NAME Last
First l Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City State F_
Zip I Telephoned
CONTRACTOR'S NAME/COMPANY UNITED CONTRACTORS Lic. No. 949005 Class GENRAL
Contractor's Address
Contractors E-mail Address
10725 ELLIS AVE, SUITE D
City FOUNTAIN VALLEY State CA
Zip 92708 Telephone Fq49-945-0905
SETBACKS REAR SETBACKS FRONT
PERMIT NO. °•,
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. D•
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $