HomeMy WebLinkAboutM2011-0018 - Permit ApplicationWorks' Net for Building Combo Perr WI
City of N w ort Beach - Buif ding De artmen V �/ Bay RDni°J
Please print 3 copies ' �/ llt;J! (A I � CITY yr mmum b
Building �'"", Grading ("'";Drainage � I—,Elec �, Mech I� PhRZ �„� � „��
1. Project Address (Not mailing address)
Tenant Name(if Applicable)
of Work
Exist House SF
Exist Gar SF
Demo Garage SF
Add/Reconstruct Garage SF I
TOTAL HOUSE SF F
New
("`"., Add
("'"! Alter ("Demo
TOTAL GARAGE SF
Floor Suite No
# Units (if Residential);
Use
Valuation $ U
Cu Yd Cut
Cu Yd FIII
# Stories
( j 6. Contractor's Name Last �~�y) First Lic No, lU j�C� lass L�
Contractor's Address Co tfa,tor's E mail Address
(� }fin _ P � 2 y -7
City ( t I .._.... ...,,.. Ste � ... Zip '`.�� _ Telephone �11 1~ `J l L
.� e
OFFICE US1E�ONLY ENERGY P/C FEE $
,Q,6 g, ILI `[ %"-, GRADING P/C tW tF NEWPORT BEACH
Rev7118107
ELEC/MECH/PLUM P/C
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEE $