HomeMy WebLinkAboutX2021-3160 - Permit Application1111—..L—L. 41- i... rwvv.h^ Cnilrlinn k Gr%lar Parmif Annlirafunn . I '-
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- Residential City of Newport Beach - Building Division
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Comm'[ NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMI — —
WBuilding F -Grading [-'Drainage [-Elec f-Mech
F_Plum CuvdCutF CuvdFill
Project Address (Not mailing address) F- Flood
r Fire r Liq F-, Landslide F -N/A Floor Suite No
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Description of Work
Use 1 /" Const Type �-8
2 Vl) c)t/ 2 �N i MM JAI) NIOC W
d ✓ n �-S—P # Stories # Units (if Res)F
Valuation $
New/AddSFF— RemodelSFF— Garage/New/Add—, Material/Labor F,TUU
OWNER'S NAME LastN \( G U y.Q_h
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First V iV) yl
Owner's Address
Owner's E-mail Address
COL 91$ 5r*-
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City CW YJdY�' State eon
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Zip �j06OFelephoneF 6 1 7-
APPLICANT'S NAME Last 1 p V First I GA ar.f/(
Applicant's Address
Applicant's E-mail Address
City `/' 1 4-ARCHState7C W
Zip q Telephone sG 2-
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ITEC DESIGNER' NAME Last FirsLic. No.
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Architect/Designees Address
Architect/Designer's E-mail Address
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State CN
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I- - C
Zip 10 61P Telephone
9,c0City
ENGINEER'S NAME Last //
C1'hahG�C�
First Lic. No.
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Engineer's Address
Engineer's E -mai ddress
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City j jun �-wLy ISO* State / __
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Zip o�r(� Telephone �2� + 2 �j J E 2!�
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CONTRACTOR'S NAME//COMPANY
Lic. No. �— Class
Contractor's Address
Contractor's E-mail Address
City State F
Zip �— Telephone
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. ?j121J .ti0zi
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $ Z(P(o • 0y