HomeMy WebLinkAboutPV2021-234 - Permit Application (2)I Comm'I ( Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) I— Flood [— Fire r Liq (— Landslide [-N/A Floor
Suite No
Description of Work
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New/Add SFF' Remodel SF�— Garage/New/Add Valuation $
- Material/Labor
OWNER'S NAME -
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Owner's Address - ---_
Owner's E-mail Address
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City
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APPLICANT'S NAME Last
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,Applicant's Address
IApplicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME
Last
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Architect/Designer's Address
Architect/Designer's E-mail Address
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ENGINEER'S NAME Last
First Lic. No.
Engineer's Address
Engineer's E-mail Address
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State I-
' Zip � --Telephone--------
elephone
CONTRACTOR'S NAME/COMPANY
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Contractor's Address
Contractor's E-mail Address
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SETBACKS REAR ss
SETBACKS FRONT ur
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SETBACKS LEFT SETBACKS RIGHT f PERMIT NO. A J I
&�_ PLAN CHECK NO.
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PLAN CHECK FEES $