HomeMy WebLinkAboutM2009-0033 - Permit ApplicationM 2ooq-0033
Workshant for Building Combo Perm' Ba"M-
Please print 3 copies City of Newport Beach - Building Dep�,rtqd
CITY OF NEWPUR', ut
F—,BuildingGrading F-Drainage f— Elec
F MeCLkr_P "M7 -1 2-
1. Project Address (Not mailing address) Floor Suite No
F`
Tenant Name(If Applicable) # Units (if Residential)
2. Description of Work - I Use
Exist House SF
F777
Demo House SF F
Valuation $
F
Add/Reconstruct House SF
Exist Gar SF F77
Demo Garage SF
F
Add/Reconstruct Garage SF
# Stories
TOTAL HOUSE SF
Cu Yd Cut F77
I"'" New I""" Add
F— Alter F- Demo
kA Ilyl -t,-Vf. q, r--
TOTAL GARAGE SF
F
Cu Yd Fill
F
r—: 3. Owner's Name Last
First
OF_�_wner's Address Owner's E-mail Address
F�
CityF-P7-p7State ZiTelephoner
F 5. Engineer's Name Last F7777777777 First F777777 Lic. No.
Engineer's Address
State
City F77
Engineer's E-mail Address
Zip Telephone
6. Contractor's Name Last F_E;7,_ First Fj' Lic. No. F__ Class F77
Contractor's Address
F—z s
City F State I CA
OFFICE USE ONLY ENERGY P/C FEE $
GRADING P/C FEE $
Rev 1118107 ELEC/MECH/PLUM P/C
Contractor's E-mail Address
Zip
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEE $