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HomeMy WebLinkAboutX2021-0023 - Permit Application (2)7m g 0 � j� Residential y of Newport Beach - BuildingDi �(�� xi ai`kshe�tfo�Combo'Buildin""'&Solar permit Icatio � Rx XI cit NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL 3uilding r Grading (`Drainage Y Elec Mechoa. Plum cuvdCut F_ cuvdFiu /Project Address (Not mailing address) F Flood r Fire r Liq r— Landslide [N/A Floor Suite No jD�esc`riptiofn of (Work J Use� 1 Const Type _�l luOfLIC1 ��PG jL C�cls �.�P rV d #Stories # Units (if Res) � —T��s f, c�pl�c� ��� �r,(t�ts �� New/Add SF F — Remodel SF�� Valuation $ Garage/New/Add � Material/LaborFu� OWNER'S NAME Last��5� First -Tce� Owner's Address \ 1 ,L -u 1 u Ne 'f> c, bDe, Owner's E-mail Address City state �— t� nn! 44 +C 0\)GSC'f�5\�`1�(`� 1 ` C_ tVl'�1)c �eS _ •o�v� Zip q LLk'7f Telephone APPLICANT'S NAME Last o'+f(e T S_ Applicant's Address First > 2 ©Z 43Applicant's E-mail Address �C � t'iC� �l � City ;� 1" �, l� State Fe� ZIP F7Eb7,;_64_ Telephone lel S t l �'i�9 ARCHITECT/DESIGNER'S NAME �` Last First I Architect/Designer's Address Lic. No. r Architect/Designer's E-mail Address City I State Zip F_. Telephone[� ENGINEER'S NAME Last� r t � e First U&No.� Engineer's Address Engineer's E-mail Address, City State tl Zip Telephoned CONTRACTOR'S NAME/COMPANY l>C 'P kmsJAQ-S Lic. No. Class_ Contractor's Address 2a rt contractor's E-mail Address tcJ rt :SC,;:SC,�: I� 'tftS'it" orris�vc City �� State �� )' , 'be? ZiP 6 t. b4 Telephone 14)Aq, 9431 [SETBACKS ACKS REAR G SETBACKS FRONT PERMIT NO. • O� LEFT SETBACKS RIGHTPLAN CHECK NO.ONE DEVELOPMENT NO PLAN CHECK FEES $