HomeMy WebLinkAboutM2021-0019 - Permit Application (2)00161
Pr(ntForm Worksheet for Combo Building &(Solar �Permit Application
(— Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rFbulldlng f—Grading r -Drainage r"Elec r—Mech (--Plumcu BL�C � ,ir�(i!ect Address (Not mailing address) I— Flood r- Fire r Liq dN,7� T7 0y N'ti'(.OPt�Y } �4i/G�w i�1PJlalirlt^� kmarnr l/% /.A /1 e7t_r_'-7
of Work
LjFV fVK- L14);i.
New/Add SFF —
OWNER'S NAME
Owner's Address
Remodel SFF —
Last
Pili✓ in Caw, lout}
Garage/New/Add s-_
Suite No
Stories # Units (if Ress
First r V'"Ift—
Owners E-mail Address
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city f I Ori Bich �— �ar�. tory)
I t`i,.7 state � p � �----
b t ZIP t`"1!t®(Q1) Telephone (I l.l%i•��IC,'. (01j(�jCl
APPLICANT'S NAME Last �6 �i �_G
Applicant's Address
6351 INDUSTRY WAY
Clry WESTMINSTER State CA
First McArjSso(
Applicant's E-mail Address I,
covo
ZIP 92660 Telephone(949)631-3121
ARCHITECT/DESIGNER'S NAME Last
First Llc.No. ---
AtchitecVDesigner's Address
ArchitecVDesigner's E-mail Adtlress
City �—
State �—
Zip F i Telephoner—
ENGINEER'S NAME Last PETROV
First PLAMEN Lic. No. 66947
Engineer's Address
Engineer's E-mail Address
28191 CASITAS COURT _
P.PETROV@PMA-BG.COM
City LAGUNA NIGUEL
State CA
Zip 92867 Telephone (714)717-7542
CONTRACTOR'S NAME/COMPANY
SWIFT SLIP AND PIER BUILDERS, INC Lic. No. 797052 Class
Contractor's Address
Contractor's E-mail Address
6351 INDUSTRY WAY
City WESTMINSTER
State CA
Zip 92683 Telephone (949)631-3121
SETBACKS REAR
SETBACKS
SETBACKS FRONT
PERMIT NO. RW Z 1 —00(9
LEFT
USE ZONE
SETBACKS RIGHT
PLAN CHECK NO.
DEVELOPMENT NO
PLAN CHECK FEES $