HomeMy WebLinkAboutM2019-0049 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application E�°e
r LOQ
Comm'I I— Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL '..M11K,
j—Building r Grading
oar
r—Drainage r Elec r—Mech r Plum CuYdHfPSOR R69®Wl CES DIVISION
Project Address (Not mailing address) I— Flood I— Fire r Liq j- LaQVX OF-kEWR�tT BE
5►
o
5 'oW,,
Description of Work
Use s Const Type s
Re e o
a
Iz Im one
# Stories #Units (if Res)
`
/�// IDi
� 15/X I r/ t1
U
Valuation $ /n p
Material/Labor I �k 000
New/Add SF
Remodel SF Garage/New/Add
OWNER'S NAME
Last F ME.. � First
Owner's Address
Owner's E-mail Address
pp
�v
City A(�/ ^ State I / ,V/ ` /k Zip TelephoneF
APPLICANT'S NAME
Last CHUNG First PACQUELYN
Applicant's Address
Applicant's E-mail Address
6351 INDUSTRY WAY
JACQUELYN.CHUNG@SBCGLOBAL.NET
city ESTMINSTER
State CALIFORN Zip 92683 Telephone949.631.3121
ARCHITECT/DESIGNER'S NAME Last First I Lic. No. F_
Architect/Designer's Address
ArchitecVDesigner's E-mail Address
city
State �— 'Zip �— Telephone
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. 797052 Class
Contractor's Address
Contractor's E-mail Address
6351 INDUSTRY WAY
ACQUELYN.CHUNG@SBCGLOBAL.NET
City ESTMINSTER
State CALIFORh Zip 92683 Telephone 949.631.3121
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $
Fl . Al
G &4 ��2--