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HomeMy WebLinkAboutX2021-3144 - Permit ApplicationWorksheet for Co i' Residential Mbo Building &Sol Permit NOTE- pity of Newport Beach - Building ar - nll( A rnq LAN CHECK F DUE g Dit'ision J �pliC�f!®n SWp r Grading I-Draina EES AT TIME d ° ge f- Elec OF SUBMITTAL 21 _ ` t -`Meet Address rMech u (Not mailin Plum 9 address Cucu vd cut L lZZ i ) Flood cu Yd Fill s Fire j' Liq �- Landslide Descriptt of W rk -- - _ floor - -- ---- _ _ � Suite N MO � SOLA ">5� L! V/ '� to // Use ��'- — - --- I) St (du)11� Com(^V l ConstTYpe� New/AddSFr�- -- �pv 4 � / ,' #Stories ��s # Units - --- _ RemodelSFr�� -'/ (if Res) OWNERS Garage/New/Add �� - NAME Valuation $ /� Last - - _ Material/Labor LJ7 Owner's Address -- -- � - a - First - rz jo L Owner's- City E-mail Address State--�i11?_gUt° AS q PPLICANT'SNAME Zip Last Applicant's Applicant's A --- �•CD1A� Telephone q 1 ddress -"'"= G --lc��gz Cis ----- First ll.(fdL city Applicant's E-mailAddress -- State - (VIP ARCHITECT/DESIGNERS NC� Zrp 9��� --- AM,�sJSafart, 'E - 6. Telephe �� si5 - - Architect/Desi ----- p ' gnarlLast s Address on I -- Firsts�� -- - Lic. No. - -'- -- Architect/Designer' goers Cify - ` E -Mail -Address - State ENGINEER'S � Zip - - _, �- --- - - - Telephone��"�= NAME F77Last d�Js� Engineer's g Address_ - -,� -- First Ci Engineer's E-mail Add'r Lic. No. x'-707 $i1 City _ ass 'Y State- 50 e CO CONTRACT ORSNZrp MPANY AME/CO -rate hone - ;ontractor's Address Lic No. �9yt Contractor's Class r,nBAA ity E-mailAddress b !dt �t�� 1J12 Gr/12�PL2q State �. - - Zip "BACKS REAR Telephone BACKS LEFT —�� SETBACKS FRONT � y j 1 1 ZONE SETBACKS RIGHT }PERMIT N0. DEVELOPMENT NO a PSNCHECK NO