HomeMy WebLinkAboutXR2022-2920 - Permit ApplicationPrint Form WOf<'ksheet for Combo Bufldling ifs 50Uar Ir 01°1311t Y1ppviCoalT10n
City of Newport Beach - Building Division
r Comm'I Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL -PC Z02- . 27
['Building r Grading rDrainage r
Elec Mech Plum Cu Yd Cut Cu vd Fill F
Project Address (Not availing address) Flood Firer Liq � Landslide I -N/A Floor Suite No
5 ��c�irJ�i�tJ �'c, NcJ �3�t�CIH , Cfl `1Q661..e _ F
f
Description of Work i g 70 L 6' S,�_
1 i"JrGV_ r:�,�
Use I— Const Type
# Stories7- # Units (if Res)F7
Valuation $
New/Add SFF — Remodel SF Garage/New/Add �� Material/Labor �f
OWNER'S NAME Last First 0 L —
Owner's Address 16 t7 �5 5H Ri -15 _1D � FL-PrGc�
R2 Owner's E-mail Address
f�(3"-1)_Q(.'-_C"0�___...___._.
City I\J.EAJO _�_.__ __.... G State F Zip 66 Telephone
APPLICANT'S NAME Last L� l� First l`'i (a (� I J
Applicant's Address Applicant's E-mail Address
M t'CCkT I .1 j'( F) RC Co r)-V JG`F( a iJ CDk`1 1'7(�,(kT r'J cT( C)o C _ &OH
--- -_..
cityi<F1 ld.—SG&(OTr-c State C (� Zip I �� �{ Telephone
P
--------- --- - ---
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State �— Zip�— Telephone
ENGINEER'S NAME Last First Lic. No.[
Engineer's Address Engineer's E-mail Address
City State I Zip Telephone
CONTRACTOR'S NAME/COMPANY Lic. No. `�.�.�L ( Class
Contractor's Address Contractor's E-mail Address
..........
City State F_ Zip[ Telephone
SETBACKS REAR
SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
PERMITNO.
PLAN CHECK NO.
PLAN CHECK FEES $