HomeMy WebLinkAboutX2020-1926 - Permit Application?nm Form; ; worKsheet for comuo building & soiar Permit Application
rcomm'I residential City of Newport Beach - Building Division �l� 11 , (/i 2 / _
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITT / I9 -t
[wilding (': Grading rDrainage r Elec r Mech r Plum Cu Yd Cut Cu Yd Fiji'
Project Address (Not mailing address) rl Flood r Fire r Liq F_ Landslide rN/A Floor Suite No
1 c3--+ g S6 u 6, F F
Description of Work ( ^ /
TA�f_cior �fvu4 e,I lJ ..I �oa S.-'i+t- 4���i'on
Use F_: Const Type VB
# Stories , # Units (if Resf
lot} of g Valuation9�% ®
New/Add SF Remodel SF � Gara e/New/AddI Material/Labor S`�/
OWNER'S NAME Last
Owner's Address
ll�t MfVY)54el0
City I Of V ?"V Qat" State r
APPLICANT'S NAME Last I A ISoi,1
Applicant's Address
1-f�l w0t,
City I 9t ! iel ower State CA_
First( jeCrV%,P-
Owner's E-mail Address
Zip
First
�A4 Cifles E,
Applicant's E-mail Address
Zip ?0'}06 Telephone Du� U 3F;,1.5
ARCHITECT/DESIGNER'S NAME Last First F
Lic. No. F_
Architect/Designer's Address
City State r
Architect/Designer's E-mail Address
Zip Telephone) u
ENGINEER'S NAME Last f}ISon First Ken Lic No.
Engineer's Address,
Ample 4A
City Yje��Y'OW2� State CFCX_ _
Engineer's E-mail Address
MCC D-00—LZC 3 -AA -q'. I . (Ove
Zip iTelephone aka 5830
CONTRACTOR'S NAME/COMPANY / nJr Lic. No.
�10 S Class�3G (PCC ?- I l - ci
`Coohtra�ctor's Address
�{f t� �i� ?y �� P,/ Contractor's E-mail Address
State GA _ Zip �J 3 Telephone 7/j "tel
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK N t �
USE ZONE_) DEVELOPMENT NO PLAN CHECK FEES $ 4
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