HomeMy WebLinkAboutX2021-2985 - Permit ApplicationF- Comm'I r Residential City of Newport Beach - Building Division o �
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL S,Qoa.,.
FEBuildingrading j�Drainage rElec �Mech Plum CuYdCutCu Yd Fillss (Not mailing address) C Flood Fire f-, Liq f- Landslide 7N/A Floor Suite No
Description of Work
Use — Const Type
9v r= --W � T- Y�cs � cy� �-� �-i�-C>i= Fc--<t°T t��f
#S ries - # Units (if Res)
New/Add SF� Remodel SF Va_ etion $ p'
�D �� Garage/New/Add Material/Labor l `) D040
OWNER'S NAME Last (%qty G_ _ First L-UA-�
Owner's Address Owner's E-mail Address
City NJE W-�C3-(L"( 1�--/�c�2'� . State�� Zi -- - — — — - - - -
P E; 2V Telephone�—
APPLICANT'S NAME Last to yr L/ ` f First t
NA Applicant's AddreAs Applicant's E-mail Address
–. Wim—
'i � �tY Iii l2Y `9.0 ✓ •\C-� �eli W")
Cit --- ---_-- — _
Y — State Zip `" . ` Telephone -71
r �ic9
ARCHITECT/DESIGNER'S NAME Last
_ — _ —First Lic. No. Architect/Designer's Address Architect/Designees E-mail Address
City F_— -- _ State ZIP �- Telephoner _ --
ENGINEE, "S NAME Last
First Lic. No.
Engineer's Address 9 �`
Engineer's E-mail Address
City State Zip F Telephone -777
CONTRACTOR'S NAME/COMPANY
c 6�z t _b c Lic. No. ' a 7� Class
Contractor's Address Contractor's E-mail Address
��. v � iP�,:L _ �t�a t L 7 i � J 1 =F'±. U9 f^-�- {�^Jci� �•Y%GC:l i...i i..5 �'" O
City State r i zip Telephone s e -
P F 9 6 i 1 i� . 1 J
SETBACKS REAR SETBACKS FRONT
PERMIT N0.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK N0.
USE ZONE DEVELOPMENT N0PLAN CHECK FEES $ t /" 'X $�`��
" '�I.�