HomeMy WebLinkAboutX2021-3408 - Permit ApplicationF- Comml r Residential City of Newport Beach - Building Division t1
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) r- Flood F_ Fire (- Liq F— Landslide
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New/Add SF -
Remodel SF1777- Garage/New/Add
OWNER'S NAME Last
Owner's Address
City t/2v / P u f .._ i 4 State (�
APPLICANT'S NAME Last LC) re
Applicant's Address
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First M y< g
Owner's E-mail Address
Zip 19 7_6 C 0
First
IValuation $
Material/Labor 9Uj
Cu Yd Fill
r—N/A Floor
Suite No
Use [ Const Type
# Stories # Units (if Resf
Applicant's E-mail Address
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Zip yl ��j I Telephone 9o) G 30 3 G
ARCHITECT/DESIGNER'S NAME Last —
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Architect/Designer's Address
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City State L
Lic. No
Architect/Designer's E-mail Address
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Zip Telephone T09 Z� Z_..' G�C)T7
ENGINEER'S NAME Last Tf M
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Engineer's Address Engineer's E-mail Address —7 [, LSS
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City ° n State GA Zip�F 2€rj } Telephone ��)S f� 2 3
CONTRACTOR'S NAME/COMPANY ft A' l . e , �&S �o r a ,� v n Lic. No. � Class
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Contractor's Address
City �✓fh d C G u h State Gr}
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT
SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
Contractor's E-mail Address
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Zip ff l i y j _ Telephone qqo "0 1.100
PERMIT NO.
PLAN CHECK NO. 1014
PLAN CHECK FEES $