HomeMy WebLinkAboutX2020-0464 - Permit ApplicationLJ Lomm'I [ Residential city of Newport Beach - Building Division .-
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
❑Building O Grading ODrainage O Elec O Mechplum
❑ Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) ❑ Flood O Fire O Liq O Landslide ON/A Floor Suite No
Y vl,V1 F-1
Description of Work F-7
Use 0 C nstType
# Stories "# U� ,,,( �es)
New/Add SF � Remodel SF� Garage/New/Add �— valuation $ �L
Material/Labor
OWNER'S NAME Last
First
Owner's Address _ [`
Owner's E-mail Address \\1
City^I � �
—� State L Zip Telephoned
APPLICANT'S NAME - Last ��
First
Applicant's Address �
Applicant's E-mail Address r
City I State
ZiPTelephoned
ARCHITECT/DESIGNER'S NAME
' Last �—� First
Architect/Designer's Address
Architect/Designer's E-mail Address Lic. No.
City r----,
State Zip TelephoneL l (�
ENGINEER'S NAME Last ��J
First Lic No..
Engineer's Address Engineer's EE -mail Address
:City
State Zip Telephoned
CONTRACTOR'S NAME/COMPANY l ,
ffiL/�G1/ /t C l%b / �f//lam /��%Lic.No. lLl<I / Class
Contractor's Address Contractor's E-mail Address
,r
City ✓t4�C State/'� Zif
' L'''7 � p fro � � Telephone ;7=.r `rt:�,
SETBACKS REAR SETBACKS FRONT M ,
PERMIT NO. ,��V L-1
SETBACKS SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK N0. �"7 W
USE ZONE DEVELOPMENT NO
_ PLAN CHECK FEES $ i