HomeMy WebLinkAboutPV2022-0408 - Permit ApplicationL PrintPorm I Workshee't for Combo 80ding -& SO[,c�r, Permit Application P0.
City of Newport Beach - BuildingDivision �jO2
Comm'I r Residential OTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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F -Building FW Grading r—Drainage Elec f— Mech F- Plum Cu Yd Cut F_
Cu Yd Fill F_
Project Address (Ac)l mall1Tig meld ass) I— Flood F. Fire F_ Liq F_ Landslide rN/A Floor Suite No
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Description of Work
Use � ,M Const Type
f # Stories _?, # Units (if Res)
e,
Valuation $
New/Add SFF—� Remodel SF Garage/New/Add w Material/Labor L
OWNER'S NAME Last
First
Owner's Address Owner's E-mail Address
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City � � ) �1..1 � - State I _.. _
Zip_b.�_ Telephone i
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
City f�� �r - State Zip Telephone
ARCHITECT/DESIGNER'S NAME Last First
- . Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
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City State Zip Telephoned-7
ENGINEER'S NAME Last �hurn,.� First Lic. No.
Engineer's Address Engineer's E-mail Address
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City I StateF_ Zip I Telephonel_—,
CONTRACTOR'S NAME/COMPANY Lic.
No. ..Class
Contractor's Address Contractor's E-mail Address
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City . /r ..5, State C�r... Zip ... � L�� Telephone Se Z..y/ 7. YP
SETBACKS REAR SETBACKS FRONT paRvff-fto ` 6,242
SETBACKS LEFT SETBACKS RIGHT PLA b4E 3}(�IdO. J to 22' 0+0 �
USE ZONE DEVELOPMENT NO "D102,1, ()V 4 PLAN CHECK FEES $