HomeMy WebLinkAboutM2019-0030 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Applicatio
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W O 030 City of Newport Beach -Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF S 1
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Floor Suite No
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Description of Work Use onstrype
51 ler �1t 1 >rm IIK�-Fo -U
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Valuation $
New/Add SFJ— Remodel SF Garage/New/Add
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OWNER'S NAME Last sV° r ll� First
Owner's Address f �i ( w
Owner's E-mail Address
15 coy-por `PIMP Drive Kdi�C �Z+1tene�st�rn�ow�s�corn
city —ewvD Ft State r ( Zip ?_WD Telaphone 4C{ - E3-3 te; U
APPLICANT'S NAME Last CHUNG First PACQUELYN
Applicant's Address Applicant's E-mail Address
5351 INDUSTRY WAY ACQUELYN.CHUNG@SBCGLOBAL.NET
City ESTMINSTER State CALIFOR�Zlp 92683 Telephone 949.631.3121
ARCHITECT/DESIGNER'S NAME LastFirst f —
Llc. No, r
ArchltectlDeslgner's Address ArohitectlDesigner's E-mail Address
City �— State �— Zip r-- Telephonsr —
ENGINEER'S NAME Last PETROV First LAMEN Lic. No. 6947
Engineer's Address Engineer's E-mail Address
8191 CASITAS COURT PETROV@PMA-BG.COM
City LAGUNA NIGUEL State CALIFORh Zip 2677 Telephone 714.717.7542
CONTRACTOR'S NAME/COMPANY SWIFT SLIP DOCK AND PIER BUILDERS, INC. Lic. No. V97052 Class
Contractor's Address Contractor's E-mail Address
8351 INDUSTRY WAY ACQUELYN.CHUNG@SBCGLOBAL.NET
CityV�VESTMINSTER State ALIFORh Zip 92683 Telephone 949.631.3121
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SETBACKS REAR SETBACKS FRONT PERMIT NO. _;Agff4-R�
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 98F,6. =a ( el
USE ZONE DEVELOPMENT NO'%A1�1 • �) PLAN CHECK FEES $ ` r�