HomeMy WebLinkAboutX2019-2226 - Permit Application+'nrtt Form, -j worKsneet for Combo Building & Solar Permit Application
R Comm'I r Resdenialt%_1 ZZZ {p City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL INF � ,.
[Building F_Grading rDrainage rElec(-: Mech F- Plum cu yd curs Cu Yd Fills
Project Address (Not mailing address) F7 Flood [ Fire __ Liq r Landslide rN/A Floor Suite No
112 Newport Blvd
Description of Work Use Const Type �-
Re -stripe the parking lot ------
# Stories # Units (if Res)s
Valuation $ $1 000.00
New/Add SF none Remodel SF none Garage/New/Add none Material/Labor
OWNER'S NAME Last Pacific Terrace Partners First
Owner's Address Owner's E-mail Address
16902 Bolsa Chica Rd., #203
City Huntington Beach State CA Zip 92649 Telephone 714-846-4881
APPLICANTS NAME Last
Applicant's Address
10 32nd Street., Suite 202
City Newport Beach State FA77
First
Applicant's E-mail Address
ajeheber@gmailxom
Zip 92663 Telephone 949-723-4393
ARCHITECT/DESIGNER'S NAME Last Pehe r First Rod Lic. No.
ArchitecUDesigner's Address
10 32nd Street, Suite 202
City Newport Beach State CA -
ArchitectlDesigner's E-mail Address
rajeheber@
--- ailgmail.wm
-. --- -- - ------- -------------
Zip RN3 Telephone 9-723-4393
ENGINEER'S NAME Last First r Lic. No.F_
Engineer's Address
City State
Engineer's E-mail Address
Zip ; Telephone[
CONTRACTOR'S NAME/COMPANY Lic. No.-, Class!
Contractor's Address
City State r
SETBACKS REAR
SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
Contractor's E-mail Address
Zip I- Telephoned
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEES $