HomeMy WebLinkAboutM2019-0063 - Permit ApplicationPrint Form W7 sh et for Combo Building & Solar Permit p Application a
r Comm'I Residential sion
NOTE: PLAN CHEKOF ES UEATTIME OFeach - Building ISUBMITIrALUBLIC WOR So�Ew�R)
FCBuilding r Grading Drainage r Elec r Mech
r Plum CuYdCut HARE PERMIT
Project Address (Not mailing address) Flood r Fir Li li rN/A o
Description of Work
Use ConstType
# Stories #Units (if Res)
AL>h iz � i�aac&
Valuation $
Material/Labor C ll
New/Add SFF- Remodel SF. ( - Garage/New/Add
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OWNER'S NAME Last 'J�EI
�r�
First �S1
conv�
Owner's Address
Owner's E-mail Address
City T17ti Z-y„�r�,? State Cli
Zip �j.'lola TelephoneFT, Ci 1t -'iZ
APPLICANT'S NAME Last CHUNG
First PACQUELYIN
Applicant's Address
Applicant's E-mail Address
351 INDUSTRY WAY
JACQUELYN.CHUNG@SBCGLOBAL.NET
City ESTMINSTER State CALIFORI\
Zip 92683 Telephone 949.631.3121
ARCHITECT/DESIGNER'S NAME Last
First F_
Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City State F_
Zip TelephoneF
ENGINEER'S NAME Last PETROV
First PLAMEN Lic. No. 6947
Engineer's Address
Engineer's E-mail Address
8191 CASITAS COURT
P.PETROV@PMA-BG.COM
City LAGUNA NIGUEL State CALIFORN
Zip 92677 Telephone 714.717.7542
CONTRACTOR'S NAME/COMPANY SWIFT SLIP DOCK AND PIER BUILDERS, INC. Lic. No. 97052 ClassF
Contractor's Address
Contractor's E-mail Address
6351 INDUSTRY WAY
ACQUELYN.CHUNG@SBCGLOBAL.NET
City ESTMINSTER State' ALIFORN
Zip 92683 Telephone949.631.3121
/
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SETBACKS REAR SETBACKS FRONT
PERMIT NO. W k k
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. 4-Zdjq
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $