HomeMy WebLinkAboutX2021-0716 - Permit Application__. v. •.ua At.771.1A11;dT1Of1 „NEw"O4?\
Comm'I �` Residential City of NewportBeach - Buildin Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTALx Z��a — o t o=
I—Buildin ro. ,. n
g r Grading F--Drainage F Elec F Mech { �--
I—Pium Cu Yd Cut l Cu Yd Fill
Project Address (Not mailing address) Flood r Fire ( Liq LandslideN/A Floor
1VF, r-_�a
Description of Work To t,���t � g� j�] � �p 577 AJ6 I —
YW a /i 04'pi Aqd T�_/"r �� ���� e ®R a p S Use � Const Type
�'� ��' ��jc.7"`G. �J i"r # StoriesfT # Units (if Res)rT
New/Add SF gl 2 (( Remodel SF // p t Valuation $
o2 _/ ;z Garage/New/Add �— Material/Labor jt�
OWNER'S NAME �LM
Last Firs/ L
Owner's Address N t
37 M AAAI S,� t L Owner's E-mail Address
State
ZIpTelephone q
APPLICANT'S NAME
Last
_ First
Applicant's Address
Applicant's E-mail Address
City State
Zip Telephone--
ARCHITECT/DESIGNER'S NAME
Last�o zo FirstF_
ArchitecUDesigner's Address Lic. No.
Architect/Designer's E-mail Address
City
Ffi-' State � �%,!j - Zip C� Telephone
ENGINEER'S NAME Last /
S First L Lic. No. %� �7
Engineer's Address
(�Q® /J Q Engineer's E-mail Address
7J �� c q(E
City 70C X State——
CONTRACTOR'S NAME/COMPANY Telephone
Zlp 6 335
-..
Contractor's Address Lic. No Class
Contractor's E-mail Address
City State [,pp Zip � Telephone--
SETBACKS REAR i i/j=3ETggCKS FRONT
SETBAC T� -- = PERMIT N0. a 1 I
SETBACKS RIGHT
USE Z PLAN CHECK NO. Z>
� . � ' ,��- � DEVELOPMENT NO
PLAN CHECK FEES $ ?2) ot_