HomeMy WebLinkAboutX2021-2905 - Permit ApplicationVV111"W vunuruy Or Ouldf r-errrllt Applicatl0 tl 'w"°'+m
Comm'I r Resident! City of Newport Beach -Building Division�'7 -
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL .�
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Project Address (Not mailing address) C Flood F_ Fire f- L!q (- Landslide [N/A
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CA � 9.Nacti YG F F_
Description of Work
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New/Add SF[ el SF Valuation $
Remod
Garage/New/Add r—� Material/Labor -�
OWNER'S NAME
Last� e�.c.� .._._ FirstTfi ' —_j .r
Owner's Address - --
Owner's E-mail Address
City rkf iwI?Or+- (3aa-(,k State �. 9 7
Zip 1 i �s_ O Telephone
APPLICANT'S NAME Last
��)r�e.r First "i—l'svI
Applicant's Address Applicant's E-mail Address
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`�Rcl'R'ECfi/B[�IGNER'S NAME Last T
First 6� Y a-�' Lic.No. �`-_. _
Architect/Designer's Address Architect/Desig11 ne s -mall Address
City � -
State �.--- Zipr---- Telephoner•.---
ENGINEER'S NAME Last` > r First Lic. No.
Engineer's Address
Engineer'smal�ss ,
.City �. State Zip F Telephoner___
CONTRACTOR'S NAME/COMPANY j d 1$ Sc te,,r'pey _9-� Lic. No. 711 5 � 3 Class G
Contractors Address Contractor's E-mail Address
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SETBACKS REAR SETBACKS FRONT } '
PERMIT NO. ✓'°' `i. ,�1_s'>
SETBACKS LEFTSETBACKS RIGHT -
f PLANCHECKNO:77
USEZONE� DEVELOPMENT NO 5 ✓A
o PLAN CHECK FEES $