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HomeMy WebLinkAboutM2024-0019 - Permit Application�Ewoopr Print Form Worksheet for Combo Building & Solar Permit Application o e r Comm'I (� Residential NOTE: PILANCH Kty of Ort FEBES UEeach - A i E 50t31rnRLdM3N d0 FBuilding r Grading rDrainage r Elec r Mech r Plum cjd 93d HGGP dH Project Address (Not mailing address) r Flood r" Fire r Liq r AC)Suite No 2270 Channel Rd. Newport Beach, CA 92661 r. XAIQ KS Description of Work l/ts r I i"�t��y gS�O`�ngIrc�fn6Lff NfWF �Jr �VS�-�rJ° Reusing Pile guides and cleats. CITY Va� 1 oZ. 7 Material/Labor $9' New/Add SFF— Remodel SF Garage/New/Add �— OWNER'S NAME Last Harrison First Pat Owner's Address Owner's E-mail Address 2270 Channel Rd. I City Newport Beach State CA Zip 92661 Telephone 949-675-4835 APPLICANT'S NAME Last Boyett First Chantele Applicant's Address Applicant's E-mail Address 6791 Klondike Ave. chantele@southshore-marine.com City Westminster State CA Zip 92648 Telephone 562-592-1357 ARCHITECT/DESIGNER'S NAME Last First F— Lic. No. Architect/Designers Address Architect/Designer's E-mail Address City State �— — Zip �— TelephoneF ENGINEER'S NAME Last Jackson First Max Lic. No. A-1082069 Engineer's Address Engineer's E-mail Address 6791 Klondike Ave max@southshore-marine.com City restminster State CA Zip 92683 Telephone 714-732-6127 CONTRACTOR'S NAME/COMPANY South Shore Marine Construction Lic. No. 1082069 Class FA Contractor's Address Contractor's E-mail Address 6791 Klondike Ave. max@southshore-marine.com City Westminster State CA Zip 92683 Telephone 562-592-13357 SETBACKS REAR SETBACKS FRONT SETBACKS LEFT SETBACKS RIGHT PERMIT NO.�/�� PLAN CHECK NO. C V �b USE ZONE DEVELOPMENT NO PLAN CHECK FEES $