HomeMy WebLinkAboutX2012-1236 - Permit ApplicationZ 0 lz - i23E
El nni Forlm 's Worksheet for Building Combo Permit Application �'! 0alba(A
Comm'I City of Newport Beach - Building Division 61'j Li W
(KI [i Residential NOTE: PLAN CHECK FEE DUE AT TIME OF SUBMITTAL ) "J G &
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nBuilding FI Grading
[7Drainage nElec [j Mech F7 Plum Cu yd cute Cu Yd Pill 1-1
Project Address (Not mailing address) Floor Suite No
3138 W. BALBOA BLVD. _ _ _ _ i ,
Description of Work
Use
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"SAMEAZOJ
# StoriesF # Units (if Res)n
-ACALCAFF"
Valuation 5
Material/Labor 516oU
New/Add SFF----7
Remodel SF7 Garage/New/Add-7
OWNER'S NAME
Last L���� = First i
Owner's Address
Owner's E-mail Address
_c
City E-y_,"C: ----
_. _ State Zip — --�Telephone(ILfi�' Cj i _ _ `. gR 0
APPLICANT'S NAME
Last DEL GATTO First TIFFANY
Applicant's Address
Applicant's E-mail Address
261 S. PACIFIC ST.
tiffany@westrnsign.com
City SAN MARCOS State CA Zip 92078 Telephone 760-736-6070
ARCHITECT/DESIGNER'S NAME Last �_--- — Firsti Lic. No. J
Architect/Designer's Address
Architect/Designees E-mail Address
City—
State I I Zip F__7 Telephonel�
ENGINEER'S NAME
Last First F_ Lic. No.F___7
Engineer's Address
Engineer's E-mail Address
city
y _
._I
�—; Zip I Telephone
State
CONTRACTOR'S NAME/COMPANY WESTERN SIGN &AWNING LIc. No. 863570 Class C45
Contractor's Address
Contractor's E-mail Address
261 S. PACIFIC ST
tiffany@westrnsign.com j
City SAN MARCO1 1-S
State CA Zip 92078 Telephone 760-736-6070
ENERGY P/C FEE $
FIRE P/C FEE $ PERMIT NO.
GRADING P/C FEE $
PLANNING P/C FEE $ PLAN CHECK NO, (0
ELEC/PLUM/MECH P/C FEE $
PLAN CHECK FEE $
DEVELOPMENT #
TOTAL FEES PAID $