HomeMy WebLinkAboutX2021-3425 - Permit Application"J Worksheet for Combo Building 5 Building Solar Permit Applioation
City of Newport Beach -gg
NOTE: PLAN CHECK FEES DUE TME OF SUBMITTAL F
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oject Address (Not mailin cuydCut�
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62 Newport Coast Dr I— Fire f Li
9 r Landslide j-N/q Floor Suite No
Description of Work I n r
'move and replace (6) (E) antennas for O 6 (N) - v as, Install ` 1
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ease area. () (N) RRUS, Install (2) Use Const Type
New/Add SF # Stories7 # Units (if Res)f—
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Remodel SF �—
Garage/New/Add F� Valuation $ 25,000
OWNER'S NAME Material/Labor
Last ounty of range o r- g,
Owner's Address I V
00 N. Flower St #400
City ffnta Ana
APPLICANT'S NAME
Last
First
Owner's Address
State A
Zip
Telephone
Applicant's Address
First Pamien
4310 Moulton Pkwy. Suite O #1009 Applicant's E-mail Address
City a9una Hills
pichardo@coastalbusinessgroup.net
ARCHITECT/DESIGNER'S
State Zip 22637
NAME
Telephone 49-336-1550
Last ASA Industries, Inc
Architect/Designer's Address
First r
430 E. Miraloma Ave. Suite DLic.
No. 41035
Architect/Designer's
City naheim
E-mail Address
jugo@casaind.com
State � p 807
Zi2
ENGINEER'S NAME
Telephone
310) 989-6740
Last
Ina
Engineer's Address
430 E Miraloma Ave.
First aul C
Lic. No. 41035
Suite D
Engineer's E-mail Address
City naheim —_
State Zip 2R07
CONTRACTOR'S NAME/COMPANY
Telephone
I
Contractors Address
Lic. No.
p
L� t{j ,�3 Class
Contractor's E-mail Address
City
State F
Zip ( —
Telephone
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PLAN
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DEVELOPMENT NO
CHECK NO.
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PLAN CHECK FEES
$