HomeMy WebLinkAboutX2020-2874 - Permit ApplicationCity of Newport Beach - Building Division Y A) • 'Z7 14 9aop =
/:ial NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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on of Work
Use F; Const Type F
# Stories[— # Units (if Res)F-
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Valuation $ 7 e�� 00
iew/Add SF�— Remodel SF�— Garage/New/Add Material/Labor
OWNER'S NAME Last CgA,i0. First
Owner's Address
Owner's E-mail Address
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City I Cab Me5& State �—
Zip Telephone (qqqoj- 14S5
APPLICANT'S NAME Last 1��0.
First _TD
Applicant's Address
Applicant's E-mail Address
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City
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Zip �1 Telephone (q iq %4 � -1q SS
NAME Last
First �— Lic. No. F_
Architect/Designer's Address
Architect/Designer's E-mail Address
City State �—
Zip �— Telephone�—
ENGINEER'S NAME Last
First �— Lic. No.1
Engineer's Address
Engineer's E-mail Address
City �— State �—
Zip F— TelePhoneF_
t� �- Lic. No. �p2 232 f lassF
CONTRACTOR'S NAME/COMPANY -1
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Contractor's Address
Conntrractor's E-mail Address
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City M(no_ State d
Zip g15:1 Telephone � A(, 6q7 1aS5
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SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $