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HomeMy WebLinkAboutM2019-0049 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application E�°e r LOQ Comm'I I— Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL '..M11K, j—Building r Grading oar r—Drainage r Elec r—Mech r Plum CuYdHfPSOR R69®Wl CES DIVISION Project Address (Not mailing address) I— Flood I— Fire r Liq j- LaQVX OF-kEWR�tT BE 5► o 5 'oW,, Description of Work Use s Const Type s Re e o a Iz Im one # Stories #Units (if Res) ` /�// IDi � 15/X I r/ t1 U Valuation $ /n p Material/Labor I �k 000 New/Add SF Remodel SF Garage/New/Add OWNER'S NAME Last F ME.. � First Owner's Address Owner's E-mail Address pp �v City A(�/ ^ State I / ,V/ ` /k Zip TelephoneF APPLICANT'S NAME Last CHUNG First PACQUELYN Applicant's Address Applicant's E-mail Address 6351 INDUSTRY WAY JACQUELYN.CHUNG@SBCGLOBAL.NET city ESTMINSTER State CALIFORN Zip 92683 Telephone949.631.3121 ARCHITECT/DESIGNER'S NAME Last First I Lic. No. F_ Architect/Designer's Address ArchitecVDesigner's E-mail Address city State �— 'Zip �— Telephone ENGINEER'S NAME Last PETROV First PLAMEN Lic. No. 6947 - Engineer's Address Engineer's E-mail Address 8191 CASITAS COURT P.PETROV@PMA-BG.COM City LAGUNA NIGUEL State CALIFORN Zip 92677 Telephone 714.717.7542 CONTRACTOR'S NAME/COMPANY SWIFT SLIP DOCK AND PIER BUILDERS, INC. Lic. No. 797052 Class Contractor's Address Contractor's E-mail Address 6351 INDUSTRY WAY ACQUELYN.CHUNG@SBCGLOBAL.NET City ESTMINSTER State CALIFORh Zip 92683 Telephone 949.631.3121 SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ Fl . Al G &4 ��2--