HomeMy WebLinkAboutX2012-2535 - Permit ApplicationPrin �m k+ orks eet for Btailding Combo Permit Application I� Ct 9W) iW4,
F7 Comm'I _,P.-Res dential City of Newport Beach - Building Division / i1 f2C , ¢
NOTE: PLAN CHECK FEE DUE AT TIME OF SUBMITTAL %Cr J or
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riBuilding F-,Grading rDrainageYddress)
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rj Plum Cu Yd Cut l Cu Yd Fill
Project Address (Not mailing
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Floor Suite No
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Description of
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/ /,use
# Stories # Units (if Res)
Valuation$
New/Add SF �}� Remodel S Garage/New/Add
MateriaULabor nn Qb
OWNER'S NAME Last — First P2 v
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Owner's Address
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Owner's E-mail Address �.'"hl,
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City Oy ��� �l State ��
p yZ� TelephoneZI p S ycl �3l )3rU
APPLICANT'S NAME Last
First &714
Applicant's Address
Applicant's E-mail Address
41
City I I State --�
Zip F—, Telephone %/y-/%/-( yYF j
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ARCHITE /DESIGNER'S NAME Last /� l ��
c�v rl First bra S(� Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City --.-:. -; State I ----
-
Zip F_ Telephone
ENGINEER'S NAME Last C
First', Lic. No—,
Engineer's Address
Engineer's E-mail Address
City State
Zip - - Telephoned
CONTRACTOR'S NAME/COMPANYfj� :eL1
fC / Lic. No. q j j �G J Class
Contractor's Address
Contractor's E-mail Address
2_02_r5_ 5 1✓es (wkj 00
City ✓a 1 vl C i' - J State s
Zip � SZ9 Telephone DV / ! Qs 3
ENERGY`PIC FEE $' . .. FIRE P"`"FEE.$... __
-. ........_:PERMIT NK: .. la -
GRADING P/C FEE $ PLANNING P/C FEE $
�T a 701�LAN CHECK NO.
ELEC/PLUM/MECH PIC FEE $ I +i $
-
PLAN CHECK FEE $ .45y4'
CITY OF NEWPORT BE PO,LIFEES
DEVELOPMENT #
PAID $