HomeMy WebLinkAboutM2020-0038 - Permit Application (2)Print Form Worksheet for Combo Building & Solar Permit App cationU 3
r COmm'l 'P< Residential City of Newport Beach
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NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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ascription of Work
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OWNER'S NAME f Materlalllor
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Owner's Address ,✓ v 1 First k ri V I VI
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`(0' -2-Owner's E-mail Address
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city ���, i3�C� Gly state FEE- zip
APPLICANT'S NAME j'� Telephoned I : Z
Last i 1, First
Applicant's Address Ct Y �s
6351 INDUSTRY WAY Applicant's E -Mail Address
City WESTMINSTER
State CA ZIP 92860
ARCHITECT/DESIGNER'S NAME Last Telepho C(9 9)831-3121
Architect/Designer's Address First
Lic. No,
Architsot/Designer's E-mail Address
City �— jam------ Zip
State I f"""-- ---
9 Telephone��—
ENGINEER'S NAME
Last PETROV
Engineer's Address First IPLAMEN
Lic, No, 66947
28191 CASITAS COURT Engineer's E-mail Address
RPETROVQ'PMA-BG.C11 OM -
City LAGUNA NIGUEL state jCq
I Zip 192667 Telephone(714)717-7542
CONTRACTOR'S NAME/COMPANY SWIFT SLIP AND PIER BUILDERS
INC Lic, No. 797052
Contractor's Address Class I
8351 INDUSTRY WAYContractor's E-mail Address
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City WESTMINSTERr mar1SS�@SUjiftSIipG10Ck5
State CA Zlp 192683
Telephone (949)631-3121
SETBACKS REAR
SETBACKS LEFT SETBACKS FRONT —�nqz
SETBACKS RIGHT �- PERMIT NO.
USE ZONE PLAN CHECK N0,
DEVELOPMENT Nf? /)
PLAN CHECK FEES $ 1 ?, �4