HomeMy WebLinkAboutX2021-3288 - Permit Application (3)X 22t- a b
Pnn Wnrk_%+h1kP_f fnr [_nrth^ 0mmilrlinn SL Q^Il r Dnrmif Annlin�finn _aMl
F-; Comm'I [7 Residential/�/
City of Newport Beach - Building Division o
/6 OTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
]Building r__
Fbmfffage [Flet ❑Methj Plum Cu Yd cutCuydFill
F_--__jl
Project Address (Not mailing address) ❑ Flood -KFire [ Liq ikandslide ❑N/A Floor Suite No
Description of Work
Use f Const Type
#Storiesbor # Units (f Res)—
aluation $
Material
New/Add SF �I
Remodel SFi Garage/New/Add �I
OWNER'S NAME
Last G_ Ct First
Owner's Address
Owner's E-mail Address
City %� !3=—
- - ----
State ���II
Zi
— ---J -- — p I i Telepho e 7 X77 `% i�
APPLICANT'S NAME
Last 07� First
pplicant's Address
Applicant's E-mail Address
f
/ f
.old
City �/j
State I Zip Sy�Fc Telephone 7/•%2�j•-S/Y -
�- --
ARCHITECT/DESIGNER'S NAME Last First F Lic. No.
Architect/Designees Address
Architect/Designer's E-mail Address
City
State —j Zip F7
ENGINEER'S NAME
7Telle-phho-need
Last -�at9� First Lic. No.1
Engineer's Address
Engineer's E-mail Address °
i
Ci - - - State Zip F Telephoned I
- - --
CONTRACTOR'S NAME/COMPANY Lic. No. di;zv'2 Class
y
Contractor's Address
U
Contractor's E-mail Address
F /
PeiNs�-G o
-- ---J - �+ t.. �rpS �
City I/
V �
— .�eG _ - -- - — - — ..
�},
- I State _ -i Zip (� ' Telephone Z !T
fovr�;;01 2A
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
USE ZONE
SETBACKS RIGHT �P1.LAN CHECK NO. OW 4
�1 tomy
DEVELOPMENT NO 1 �%� '� l `�/.(PAN CHECK FEES S 1 L!' Af ✓
CITY OF NEWPORT BEACH
DEPARTMENT
COMMUNITY DEVELOPMENT
I BUILDING DIVISION
949-644-3200
PLAN PROCESSING REQUEST
Y
G
ADDRESS:
DESCRIPTION:
vv�vl5la Z -
(,c
,65
�((�j 1(� 1�J0� ry 2✓l�( lair--=-
ULAN CK #: �9✓ – ���
NEW (OTC 1 APC 1 SUBMIT)
E] RESUBMIT (recheck I process RFIU/R)(Lr
� )
EVISION (delta # pc hrs.
# of PAGES (plans 8'/=x11 1
BLDG STATUS: AP I PA I C PP
I EMP STATUS: APIPAICOIPP
T
W NEEDED: (circle requi
II DEPTIDIV REVIEI
PLNG PW EMP HARBOR FIRE GRADING
Engineer:_— date:
Contact Name & #:
FormsTlanPracessingRequesi