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HomeMy WebLinkAboutX2021-1721 - Permit Applicationf- Comm'I F- Residential City of Newport Beach - Building Division AI _X 2a 2I- 2:3 d _� NOTE- PI Ar`ur: 9V =CQ ni is nr r r -Building r Grading rbrainage NrElec MechPlum r Cu Yd cuts Cu Yd Filll Project Address (Not mailing address) f- Flood r- Fire r' Liq Landslide FNMA Floor Suite No Description of Work[���. Use ConstTypel j 3 Gown 1l� Q.1:�.ql _ V � G3 # Storiesr #Units (if Res)r Valuationi3 `. Material/Laa bor � I---.--+ New/Add SFRemodel SF r. Garage/New/Add r--- OWNER'S NAME Last Q,II' 4 First IR Owner's Address - - Owner's E-mail Address ��t<< d: ..t1 P �� '��t�04 r«9ti,i1. City /J2State - .Zip Telephone APPLICANT'S NAME Last�Y 70�" .(1M First Applicants Address Applicant's E-mail Address 032CiV032-- City ty '�.,._ u State.. Zip f Z�2"I `C Telephone f ARCHITECT/DESIGNER'S NAME Last r vvvruy� First F ILic.No.f_-__ Architect/Designer's Address Architect/Designer's E-mail Address City F.___ -__ .State Zip F_ Telephone__-.-.__._ ENGINEER'S NAME Last FjN Lt First FF6y, Lic. No.r Engineer's Address Engineer's E-mail Address City I__..—__ State r._._ Zip r_—...__- Telephoner_—_.._� CONTRACTOR'S NAME/COMPANY \a"i SJcS, Lic. No. 1Z��3 1 Class , Contractor's Address Contractor's E-mail Address CLS - - City State — Zi I P.--- Telephone SETBACKS REAR SETBACKS FRONT- PERMIT NO. - -i� SETBACKS LEFT SETBACKS RIGHT- PLAN CHECK NQ:;1�j,'' USE ZONE DEVELOPMENT NO PLAN CHECK FEES $� U