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HomeMy WebLinkAboutX2012-2179 - Permit Applicationr PnnWorksheet for Building Combo Permit Application F_ Comm r Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEE DUE AT TIME OF SUBMITTAL XZDVZ- 2 551 Neva' DQ Cenfeo c „,_ DV Xj Building F-I Grading f-Drainage f�Elec F_Mech F_ Plum Cu Yd Cut Cu Yd Fill F_ Project Address (Not mailingaddress) Floor Suite No Description of Work P 1NS114y� oA FSTtI lJ L)e1ir,$II Use # Stories # Units (if Res); Valuation$ New/Add SF Remodel SF�� Gara e/New/Add F— g - iV lSUO Material/Labor r OWNER'S NAME First Last j/21f1/V� (,(}— -...._-_ Owner's Address r"J �% Nu) G, V-to C. 4 Owner's E-mail Address / t✓ j City State F Zip I------ TelephoneF_�, APPLICANT'S NAME Last j H yL2.)A0 LT First S7Z Applicant's Address Applicant's E-mail Address - 99gt --Fa>L }(� QG1�GD `U�eV�.©5;�.��erdtUBR.cp.tn �----- City State Zip Telephone o11 511 I(p7j- ARCHITECT/DESIGNER'S NAME Last First F Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address City State Zip Telephoned._ ENGINEER'S NAME Last First j Lic. No ---- - , / Engineer's Address - Engineer's E-mail Address �__k_C. f 4, City State F777 Zip F Telephones CONTRACTOR'SNAME/COMPANY 51GNTL'?-ti Luz.1eicAL AbVotrlSrnIC Lic. No. 4S1`iU�c Class Cy$ ---- -. Contractor's Address Contractor's E-mail Address `I`�`j c �+t- - dwb City ('�)(�- State CA � Zlp `j-z 'Telephone (,�I`j „$Zl co(Uv K`/LU ENERGY P/C FEE $ FIRE P/C FEE $ PERMIT NO. xull- - 7IJIq GRADING P/C FEE $ PLANNING P/C FEE $ 31,Zra PLAN CHECK NO. ELEC/PLUM/MECH P/C FEE $ PLAN CHECK FEE $- DEVELOPMENT # TOTAL FEES PAID $ s ugUZ