HomeMy WebLinkAboutX2021-3106 - Permit Application (2)I _rainuruiiu.; _t yvu1 K,11Ctm lu, %✓•plug 6anaing be oOlar rermll Application
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City of Newport Beach - Building DivisionComml
r ResidentialNOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building F_Grading F -Drainage (-Elec�Mech -Plum Cu YdCueF77 cuvdFill
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Project /Address (Not mailing address) Flood F Fire r; Liq F_ Landslide 1 -N/A Floor Suite No
of Work
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New/Add SF UTO1--
UseConst Type IE]FTT
t # Stori Units (if Res)
f
Valuation $
Remodel SF �- Garage/New/Add �— Material/Labor
OWNER'S NAME
Lastl.%��lf)'i-icet(/—
Owner's Address Owner's E-mail Address
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_ Zip to Telephone 7
First (
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CITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT Applicant's E-mail Address
BUILDING DIVISION ` Y
949-644-3200 � f7
up PROCESSING REQUEST /1 / r-7 —�� y lam')—
ADDRESS: r r r Eip (1-).-�I `I Telephone ? ir`T
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)ESCRIPTION �`m a First
Lic. No. �—
Architect/Desi9 ner's E-mail Address
PLAN CK#:
❑ NEW ( OTC / APC / SUBMIT)
F-1RESUBMIT ( recheck / process RFI
Oft)
EVISION (delta # 2✓,w "' pc hrs ham'
# of PAGES (plans r 8'/: x11 )
BLDG STATUS: / PA / CO / PP
E1VfP ST7�iUS —CAP AP7Y'A-/-Co.l.P.2_
DEPT/DIV REVIEW NEEDED -
(circle required depts)
-
LP NG% PW EMP HARBOR � FIRE )GRADING
Engineer: E!',(__ date: E f
Contact Name & #: v-` DLA I
FDrms%PlanPmcessingRe,u st
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USEZONE DEVELOPMENT NO
Zip Telephone
First 0 Lic. No. _L, L_tt�i
Engineer's E-mail Address'
Zip.F� Telephone i�.---
Lic. No.' lass
f
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEES $