HomeMy WebLinkAboutPV2019-091 - Permit Application.._, ..v....,w vunullk cx ._�ura1 r'Cf11111,MppIIcati
Comm'I (Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL u�
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Description of work
Use I— Const Type F—
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#Stories #Units (if Res)
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Valuation S O
Material/Labor
New/Add SF Remodel -- Remodel SFI—i
Garage/New/Add �—
OWNER'S NAME Lastrj ll
First
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Owner's Address
Owner's E-mail Address
City W& -J V0C_ C,5,PS State F lj__ _
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APPLICANT'S NAME Last f- First
Applicant's Address Applicant's E-mail Address
City State �— �����1t ,,72ZipZ65jTele one
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ARCHITECT/DESIGNER'S NAME Last I First C.� � a
_ Lic.7 JI z 1,�j 1
Architect/Designers Address Architect/Designer's E-mail Address
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city 1 � ���r`.._
)c y ` llrj State F� Zip Telephone �Y�2y8�728
ENGINEER'S NAME Last` First l� Lic. No.
Engineers Address Engineer's E-mail Address
City F� State j-.—._ Zip F'_- Telephoner
CONTRACTOR'S NAME/COMPANY c�O t Lic. No.Class
Contractor's Address Contractor's E-mail Address
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City C v l�j State�— Zip q�SS�j Telephone % / 5�7�Z�U
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SETBACKS REAR SETBACKS FRONT PERMIT NO. p V zorl
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $