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F_ Comm'I Residential City of Newport Beach - Building Division
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Projectt Address (Not mailing address) F_ Flood r Fire r Liq r Landslide CN/A Floor Suite No
Description of Work
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# Stories # Units (if Res)
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Valuation $
Garage/New/Add a/New/Add — 15 �j00
9 Material/Labor
OWNER'S NAME Last 1'Yova
First
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Owner's Address
Owner's E-mail Address
City �Lt Q i State �� Zip F— Telephone
APPLICANT'S NAME Last FTVAY- V P z
First Jac
Applicant's Address
Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last First —Lic. No. F
Architect/Designer's Address
Architect/Designer's E-mail Address
City State �—
Zip s— Telephones --
ENGINEER'S NAME Last First �— Lic. No. F --
Engineer's Address
Engineer's E-mail Address C m (4C 11 O
City State �—
Zip s— Telephone —
CONTRACTOR'S NAME/COMPANY Iv�h ,' ' ' \
G Y C� �1P'Z. -�-X ��.'\ WC` r'tS Lic. No. �� �C`�5� Class F67T.
Contractor's Address
Contractor's E-mail Address
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SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $