HomeMy WebLinkAboutX2022-1043 - Permit Application (2)Worksheet four Combo Building & Solar Permit
MITTAALppl'atio
PNewport
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NOTE: LAN CHECK FEES DUE AT TIME OF SUB
r Grading rDrainage 5? Elec F Mech j— Plum Cu Yd Cut Cu Yd Fill
Gt Address (Not mailing address) I- Flood r Fire r Liq r Landslide FN/A Floor Suite No
iheringon Place I— 203
escription of Work Use ConstType
ater damage repair to bathroom - Replace 180 SF of drywall, insulation. Reset 1 existing
# Stories # Units (if Res)
o $
New/Add SFF— Remodel SF F6-- Garage/New/Add F_ MateraluatriaVLa>b 15,M,
OWNER'S NAME Last
Owner's Address
First I
Owner's E-mail Address
i
,it, F_ State F— Zip F— Telephoned—'
APPLICANTS NAME Last
First
Applicant's Address Applicant's E-mail Address
659 Pepperwood Avenue LLPERMITS@GMAIL.COM
City Fong Beach State P A— Zip P
0808 Telephone 62-746-2714
�uvcarvncna onmc Last
/.—i-tom_ ✓Z.� First —�G>J Lic. No. �—
Architect/ esigner's Address Architect/Designer's E-mail Address
I Li $ t,vraZ `j 7 `3 \. v-�
City e>w State �( Zip �p �. d Telephone
ENGINEER'S NAME Last ovelace First files Lic. No. 9734
Engineer's Address Engineer's E-mail Address
�itY �— State Zip Telephoned
WTOR'S NAME/COMPANY ignal Restoration Lic. No. F693 Class�—
"s Address Contractor's E-mail Address
1wood Avenue
ve State CA Zip Fn2r1 Telephoner14-763-4153
SETBACKS FRONT PERMIT NO.
SETBACKS RIGHT PLAN CHECK NO.
DEVELOPMENT NO PLAN CHECK FEES $