HomeMy WebLinkAboutX2021-0032 - Permit Applicationmint romnwoPICSTIeeY-Tor vomiyo ouiouling'6t Jolar rerfTTIL AppllcailoTl � mm
00'3 2, City of Newport Beach - Building Divisioo
F_ Comm'I Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBS 1A14 114". a
r`Building F_ Grading F -Drainage rElec rMech Plum CuvdCut F Cu Yd Fill
Project Address (Not mailing address) r Flood F- Fire F- Liq r Landslide CN/A Floor Suite No
Work
Use F_ Const Type F_
/of
��py/ /(q
I �tJlL� �t�
`+-t/l.'�
#Stories #Units (if Res)
�D(eescription
I c .,
C16 OL Ka
Valuation $
Material/Labor
New/Add SFF_ Remodel SFGarage/New/Add F
OWNER'S NAME Last First (�
Owner's Addr O of Address
nE-mail
Duo 0UI L
City J� ��/, } yvL� V���- Telephonef�
PLICANT'S NAME Last First
t
plicant's Address Applicant's E-mail Address
City J�Ce � State L Zip Li Telephone 3 -7i
e 6
ARCHITECT/DESIGNER'S NAME Last First r----- Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State F Zip F- Telephonel�
ENGINEER'S NAME Last tG� 2 F st Lic. No.F_
Engineer's Address Engineer's E-mail Address
h v ®z Poil 1p A C*--
City St e ' ® Telephoner-----
CONTRACTOR'S NAME/COMPANY�I c�LMn Lic. No. 71 3 Class ��
!/� J "/q V "Contractor's
Contractor's Address E-mail Address
[labs 0q, l �n
_State
City � //� Zip ,`��-7
I !NS t� Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO�Z/1
SETBACKS LEFT SETBACKS RIGHT PLAN CHEC NO.
USE ZONE DEVELOPMENT PLAN CHECK FEES $
M