HomeMy WebLinkAboutX2019-3338 - Permit Application- uu,runccu ar soiar Permit ApplicationPo s
F Comm'I Residential City of Newport Beach - Building Division c
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Buildin
g F7 Grading ("Drainage f7Elec I—Mech j` Plum
Cu Yd Cut Cu Yd Filll
Project Address (Nat mailing address) f- Flood F`. Fire i Liq F-j Landslide f_N/A Floor
Suite No
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Description of Work
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Use Const Type
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\1C1n p ✓ \ ]�hC/l�i� I/L Stories #Units (if Res)
New/Add SFI ReUmodel SF iJ ation $
Garage/New/Add Material/Labor
OWNER'S NAME Last
First
Owner's Address - - — -
Owner's E-mail Address
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city State
Ln_11�!�1 _ — ZIP Telephone
APPLICANT'S NAME'
Last �l?y7%i First
Applicant's Address
`Applicant's E-mail Address
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City I S�jrtCo
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Zip l �! Telephone -719, 3J/ c2Q-73
ARCHITECT/DESIGNER'S NAME
Last _ First
Architect/Designer's Address Lic: No. F�
Architect/Designer's E- mail Address
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State Zip 9e2��ne 7J
ENGINEER'S NAME Last
First F Lic. No. �
`Engineer's Address -
Engineer's E-mailAddress
GdyState - ---
Zip �— Telephoner—
CONTRACTORS
CONTRACTOR'S NAME/COMPANY
Lic. No. F7P 09CIass
Contractors Address
Contractor's E-mail Address
City I (y/S'l �C/!///�✓/� : State Z
Telephone C�?,23
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
TBACKS
SETBACKS LEFT SERIGHT/
PLANCHECKNO 2 .�C
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $