HomeMy WebLinkAboutX2021-3397 - Permit ApplicationI �omm'I Residential �+ " ...,•p, �Gr 11111 AppllCatl 011
NOTE: PLAN CHECK FEES DUE AT TIME O
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ential City of Newport Beach - Building Division x� UZd 317
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Description of Work
Ps7Cd G c- x ce gef rLe 7(J/ Use Const Type
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-------- # Stories # Units (if Res)
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New/Add SF— Remodel SF�—
_ Garage/New/Add �-- Valuation $
OWNER'S NAME
Material/Labor®(
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Last
Owner's Address First J
Z3 C aQ ,1 n Owner's E-mail Address
city
Zip _ <� Telephone
APPLICANT'S NAME -�' r5 r(
Last
Applicant's Address First j d
7 c7 Z 1 j
Applicant's E-mail Address
city ___--- E�`IT-{<A7'5
State -
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ARCHITECT/DESIGNER'S NAME Zip.
Last
Architect/Designer's Address First �—
Lic. No. �—
Architect/Designer's E-mail Address
City - -
-- State �- Zip
Telephoner
ENGINEER'S NAME
Last
Svc First L u
Engineer's Address - e Lic. No. [
Engineer's E-mail Address
City:
State Zip
Telephene�—
CONTRACTOR'S NAME/COMPANY
Contractor's Address Lic. No. Class
Contractor's E-mail Address
city
State �- Zip Telephone
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT PERMIT NO.
.SETBACKS RIGHT
USE ZONE _ PLAN CHECK No.
DEVELOPMENT N0
PLAN CHECK FEES $