HomeMy WebLinkAboutM2008-0043Worksheet for Building Combo Permit Application Po",
City of Newport Beach - Building Department
P'lease pr- int 3 copies
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1. Project Address (Not mailing address)
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A
No
Tenant Name(if Applicable) # Units (if Residential)
........... .............. ........ I ........................ ....................... . ....... F77
........ ........ ......... .....
(7 5. Engineer's Name Last
Engineer's Address
City
First
.............................................................. Lic. NoT777
Engineer's E-mail Address
............................................................................................................................. ;
..............................................................
I ...................................................................................................................................
State Zip Telephone
.......................................................
........................... .............................................
I ............................ . ............................... :
1.—,,,'6. Contractor's Name Last -'r. 7
I _�Ss
First
Lic No.
... ........... ..... ......... . t ..... ....... ..................... 7? ?0
.............. .....................
Contractor's Address Contractor's E-mail Address
............... �2_77_ .... . .................... r A .............
....................................................................................
city State Telephon(
zip F
OFFICE USE ONLY ENERGY P/C FEE $
I Rev 1118107
GRADING P/C FEE $
ELEC/MECH/PLUM P/C
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEE $
7
CITY OF NEWPORT BEACH HARBOR APPLICATION
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HARBOR RES 'I, '.IRCES DIV.
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Permit #
/33- Y7
DREDGING PERMIT STATUS
Comments/Date
Action Completed
Permit Received
Eelgrass
Inspection
Sent to Agencies
From Corps
From Coastal
Notified OK to
Dredge
Not Approved
Completion Report
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CITY OF 14EWPOFIT BEACH
HARBOR PERNIET
PERMISSION IS HEREBY 062!!,NTED TO CONSTRUCT AND
MA�NTAIIV THC FACILVTV SH01"AfN ON THE HEREZOF,
AT THE S -ITL �NK)ICATC.D, SUa-;E-CT 1-0 Tl% PRCVi-SJ0N-- OF
THE HARBOR P--"niVV;T PGLIC-2:S OF NEW70011"T REACH AND
ANY SP=AL TH;S Flr--rirvll�
15 NOT UE V:i-�SIVEN COHISENT U,
THE C�711( HAMS-G.i CCUNC;L. Til,
-- - -;, us-,*
IZ I G H T S G: V 1 R V NZ Er R T 1. CHL"
AND THIS PERMHT fill L K vz)4 ci 1 i'M! COUNCIL
IN ACCORDANCE WITH I T L LEE TFEE rallu ZiCIPAL CODE.
%il &HA =CGORDINATOR
/3 7 DEC 11969
PERMIT NO. �DATE
INSPECTED
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