HomeMy WebLinkAboutM2019-0029 - Permit ApplicationM2-010 - 002_q
Print Form Worksheet for Combo Building & Solar Permit Applicatio y" c
r Comm'I r Residential City of Newport Beach - Building Division 4
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
r -Building r Grading
rDrainage r Elec r Mach I- Plum c Y OR 1`112966F4 ES DIVISION
Project Address (Not mailing address) r Flood r Fire r Liq rJ1r&bEi e No
I
` 8 7 18
Description of Work
Use Const Type F
R�mo1l'
r
(a2
# StoriesF # Units (if Res)F_
New/Add SF �—
Remodel SF Garage/New/Add F
Valuation $
Material/Labor L
OWNER'S NAME
Last US First
wner's Add ss
Owner's E-mail Address
City
State 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 ESTMINS'fER
State CALIFORN Zip 92683 Telephone949.631.3121
ARCHITECT/DESIGNER'S NAME Last First F Lic, No. I
Architect/Designees Address
Architect/Designer's E-mail Address
City
State F— Zip F— Telephoned
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 LAGUNANIGUEL State CALIFORN Zip 92677 Telephone714.717.754<
CONTRACTOR'S NAME/COMPANY WIFT SLIP DOCK AND PIER BUILDERS, INC. Lic. No. 797052 ClassF
Contractor's Address
Contractor's E-mail Address
6351 INDUSTRY WAY
ACQUELYN.CHUNG@SBCGLOBAL.NET
City ESTMINSTER
State ALIFORh Zip 92683 Telephone 949.631.3121
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. I i)
USE ZONE
DEVELOPMENT NO _DJ0_V A Ij, PLAN CHECK FEES $ 30 Z