HomeMy WebLinkAboutX2019-0337 - Permit ApplicationComm'I 0 Residential City of Newport Beach - Building Division rr ~' v„ It a
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL V
FDescription
ing [Grading []Drainage �Elec ElMech Plum
Cu Yd Cut I ;_71 Cu Yd Fill
ct Address (Not mailing address) n Flood [ Fire Cr Liq F Landslide CN/A Floor
Suite No
of Work
's W h Enc- Use Const Type s
<S�/ctni i
�j S Ft Y Y 1 I # Storiesr # Units (if Res)
New/Add SF �j Remodel SF� i Garage/New/Add Valuation $
Material/LaborF-1 OWNER'S NAME Last C
1ci1 �) C First s7 V
Owner's Address —
�_ �^ Owner's E-mail Address
City I�LW— State �� ------
L� I.zip �i Telephoned;
APPLICANT'S NAME --
Last � �` e? y�f � First
:Applicant's Address
Applicant's E-mail Address
72
Q j 47 aci s^s) 2 len 2
L T� s l C�
city—� State
Zip Telephone^
ARCHITECT/DESIGNER'S NAME
Last -- First�—
Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State
I Zip .r77-1,� Telephone— --
ENGINEER'S NAME
Last _ I First Lic. No.�- i
Engineer's Address
--
Engineer's .E-mail Address
City State----. --
ZIP F- TelephoneF_ j
FSETBACKS
OR'S NAME/COMPANY —���
I Lic. No. Class
--
Address —
Contractor's E-mail Address
--i _Zip TelephoneEAR SETBACKS FRONT
PERMIT N0.
SETBACKS LEFT SETBACKS RIGHT --�!
PLAN CHECK NO. �9j=
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $