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HomeMy WebLinkAboutX2021-1421 - Permit Application....+viao rurmli H IlcatTio 1 d EW\ FR Comm'I Residential City of Newport Beach - BuildingDivision Ov�i✓i NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL i Fn Building f— Grading `(" Draina a g f-Elec rMech FPlum Cu YdCut�Cu Yd Fillroject Address (Not mailing address) r Flood Fire f7 Liq F_ Landslide FN/A Floor — r Suite No azo uld_ t�uapak _8tad. Il¢ulpa� 6earltr tt4 _92 Wis i 1 A i�' . Co -- Use wH stT e J oW uol4aye F rm Mr , RLSOavldtr d t r { ¢ S tEcvrt ado yp I l li rat d Bwon rnbb .lwm Worles #Units (if Res) New/Add SF7 Remodel SF -- Val�ua ion $ -- Garage/New/Add �— Material/Labor 5�'I ooa OWNER'S NAME Last tLel� Kt4fr11. o} USc First pJp Owner's Address i 1t21 I0"scrurts Owners E-mail Address Auer 5ke 7,00 �e9mtd� Cay ist_ SPdo State �— r _ Ck 7in A n 91 _ r — r--- .. ooN�wne('SILZ • Zaq .204} APPLICANT'S NAME Last 1 y ❑tS First � , • Applicant's Address Applicant's E-mail Address (IId0 i;!ntit Csf�t!liiti - Cay 3,� t State r__ - �ateln. yrna@ I,e comm. tem I Cir Zip Telephone ydq.'tu!•3,?l/ ARCHIT CT/DESIGNER'S NAME Las First Architect/Designer r es �; Lic No. le Architect/Designer's E-mail dress 5•',nf4 hssinc.L rrl city 1, ..Nwtfla!¢a State Zip � p3 t <f Telephone ENGINEER'S NAME Last Firstl Lic No.r--- Engineer's Address Engineer's E-mail Address '� i c 'Z_.Iitavi Ss tcke3ot 'QZo ena�, crm City Lrmn',i State r-- %A Zip a1$ � Telephone -v a -mo CONTRACTOR'S NAME/COMPANY eaA Lic. No. 1()44 Class Contractor's Address - Contractor's E-mail Address i Uoo P,a,ll{ _ vrr�,llyrs+ City �m Hy,l re @ l�"Am rin, -- $an Ltagnl� State -- - -.. Zip %;1i1r3 Telephone SETBACKS REAR SETBACKS FRONT SETBACKS LEFT PERMIT NO. �42- SETBACKS RIGHT % USE ZONE PIAN CHECK NO. DEVELOPMENT NO PLAN CHECK FEES $ 1 i"t .; __� I