HomeMy WebLinkAboutPV2022-0345 - Permit ApplicationF Comm I �` Residential ar I�OJ'fnit A l•
City of Newport Beach - Building DivisionWon—��IO�$60�NOTE: P �EV/PLAN CHECK FEES DUE AT TIME OF SUBMIV ,o�
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Project Address Cu Yd Cut
(Not mailing address) f- Flood Cu Yd Fill[- Fire Li
q Landslide IN/A
Vi_
Floor
Suite No
Description of Work ---_- _ -------------- _.____
Use Const Type
------ - -- _ ------ # Stories
New/Add SFF—�r -- # Units (if Res)[
Remodel SF -
------ _ Garage/New/Add �� Valuation $
OWNER'S NAME Last Material/Labor 7 3 ®0 • ou.
Owner's Address First
Owner's E-mail Address
City
State �—
Zip
PPLICANT'S NAME Telephone
Last A4—
Applicant's Address - First
Applicant's E-mail Address
city _.._-
_ State
---- -
aw�Zip _ ----- - -- -...
ARCHITECT/DESIGNER'S NAME Telephone -
Lastt- ----- - -------
Architect/Designer's Address - First
........... .. .
_ Lic. No.
Architect/Designer's E-mail Address
City _. _..._ _
_._ State �— _.._-.._. _ .__ Zip
ENGINEER'S NAME TelephoneIF_
Last ! --
Engineer's Address First
Lic. No.
Engineer's E-mail Address
City
-
Zip
CONTRACTOR'S NAME/COMPANY Telephone - -_._
Contractor's Address �f��
_ 0,4 sca�q� Lic. No. C3
_ % Class
Contractor's E-mail Address
City -
...............
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Telephone _.._._ _ �
y 3276i'
SETBACKS REAR 3
SETBACKS FRONT
SETBACKS LEFT PERMIT NO. PV
JSE ZONE
SETBACKS RIGHT
PLAN CHECK N0. /
DEVELOPMENT NOV-,,,, la O PC Z
-----_ PLAN CHFr.k car-,