HomeMy WebLinkAboutM2019-0053 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F Comm'I esidential City of Newport Beach - Building Division JGjy�0l9
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL j,YO�q
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Address
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Description of Work
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OWNER'S NAME Last
Owner's Address
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APPLICANT'S NAME Last
First I rress e9
Owner's E -mall Ad
Zip
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Applicant's Address
351 INDUSTRY WAY Applicant's E-mail Address
JACQ U ELYN. C H U N G@ S BCG LOBAL. N ET
City PNESTMINSTER --~�- State •CALIFORh ZIP[92683 Telephone 49.631.3121
ARCHITECT/DESIGNER'S NAME
Last First [�
Lic. No. Architect/Designees Address Architect/Designer's E-mail Address
City rte_ � State r--
ZIP Telephone --
ENGINEER'S NAME Last PETROV First PLAMEN
Lic. No. 6947
Engineer's Address 8181 CASITAS COURT Engineer's E-mail Address
P.PETROV@PMA-BG.COM
City LAGUNA NIGUEL State CALIFORt ZIP F2677 Telephone 14.717.7542
CONTRACTOR'S NAME/COMPANY SWIFT SLIP DOCK AND PIER BUILDERS Lic. No. 97052
INC. � ClassF
Contractor's Address Contractor's E-mail Address
351 INDUSTRY WAY
ACQUELYN.CHUNG@SBCGLOBAL.NET
City �TMINSTER State ALIFORN Zip 2683 Telephone 949.631 .3121
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
PERMIT NO. /1/l' 40 CI .
PLAN CHECK NO
USE ZONE DEVELOPMENT NO ���1 % I PLAN CHECK FEES $