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City of Newport Beach -Building Division
Comm'I Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Description of Work
# Stories, #Units (if Res)s,
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OWNER'S NAME Last ,I C Cr—u ),i e3a
Owner's E-mail Address
Owner's Address
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state � Zip
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City
First
APPLICANT'S NAME Lash
Applicant's E-mail Address
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State
CA Zip 9�'�S� Telephone �I�`
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ARCHITECT/DESIGNER'S NAME Last
Architect/Designees E-mail Address
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State Zip--�s-r—r7
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Engineer's E-mail Address
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CONTRACTOR'S NAME/COMPANY
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Contractor's Address Contractor's E-mail Address
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SETBACKS REARr PERMIT
SETBACKS FRONT
SETBACKS LEFT =-- SETBACKS RIGHT PLAN CHECK N0.
USE ZONE
i �"� DEVELOPMENT NO PLAN CHECK FEES $ --�