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HomeMy WebLinkAboutX2021-0267 - Permit Application (2)I residential City of Newport Beach - vnnrl q lIcation aewro r NOTE: PLAN CHECK FEES DUE AT Bui TIME OF SUBMITTf-Buildinvision AL _. 9 r Grading F -'Drainage r Elec as ' rMech rplum cuvdcut Pro Address (Not mailer N Yd Fill g address) Flood j� Fire (' Liq j` Landslide _N/A Floor Suite No 71-t� � i� Work RCD Description of Work AD U CJ l Use Const Type # Storiesf # Units (if Res) New/Add SF�— Remodel SF�- Garage/New/Add(� Valuation S OWNER'S NAME Material/Labor Last -- ^S rKn L, G� Owners Address - First Owner's E-mail Address i city �' -- TJS7 State p ' Zip 4 APPLICANT'S NAMTelephoned-�t�- E H - Last �<L.:.,_ Applicant's Address _ First N C L -`Z.-, Applicant's E-mail Address City State__ �- Zip � _ ARCHITECT/DESIGNER'S NAME Telephone's Last 27�jL� C` C ICL Firs--- �� IE�-.� Architect/Designer's t Designer'sAddress -�- L�Div� Lic. No. Architect/Designer's E-mail Address City A14C StatetZ�l Tt A Y 1 iSt� , i on Zip �- Telephone_ ENGINEER'S NAME Z(1f_P'�� Last `��G L ___._ Engineers Address --- First Lic. No.�� C� P� Engineer's E-mail Address A J C" i city ��- state �— `'�a12�1t-r2t�Y Zip Telephone� CONTRACTOR'S NAME/COMPANY Contracrs hP�'� /� toAddress ` .�1� _<Tj? 0CTt I-) Lic. No. Z)67-45 Class`' - Cis Contractor's E-mail Address City �e { �eS Cha �1�`�" �i7S_­" T^ , TL v STCO� _ State Cr — Zip ' Telephone -r _�" C l SETBACKS REAR SETBACKS FRONT �7�� f SETBACKS LEFT SETBACKS RIGHT —�- PERMIT N0. USE ZONE -- —� PLAN CHECK NO. DEVELOPMENT NO .PLAN CHECK FEES $