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HomeMy WebLinkAboutX2022-0325 - Permit Application (2)Print Form I City of Newport Beach Building Division Ap Il�i<l�J®n ®� �� eet ®r� Combo Building & �� ��° Pe�rr>�I� s Comm'I j� Residential y p g V J (�� �„ r NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMI AL j—Building j— Grading (—Drainage (+ Elec j" Mech (— Plum Cu Yd Cut Cu Yd Fill Project Address (Nog kAailing address) r Flood Fire j— Liq F Landslide rN/A Floor Suite No F I -A A) Description of Work Use Const Type (_Iul j-431 2vC+ a0 L = ©r yl z /&- t/4l Al`_ # Stories # Units (if Res)F_ Valuation $ Material/Labor 6 New/Add SF Remodel SF Garage/New/Add OWNER'S NAME (* Last r , First L jj Owner's Address Owner's E-mail Address t5AA, City �® State Zip Telephone) APPLICANT'S NAME Last � j ���,�`� First Applicant's Address Applicant's E-mail Address City State Zip Telephone) ARCHITECT/DESIGNER'S NAME Last First Lic. No. Architect/Designer's Address F_ Architect/Designer's E-mail Address City I F_ I State Zip I Telephone ENGINEER'S NAME Last r First I Lic. No.�—! Engineer's Address Engineer's E-mail Address City State F_ Zip �— Telephone CONTRACTOR'S NAME/COMPANY-�� Lic. No. F — Class Contractor's Address Contractor's E-mail Address City �— State F Zip Telephone SETBACKS REAR SETBACKS FRONT PERMIT NO. )(Zcl2 2 ` d 3 Z S SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. R► Z2-0'Lo-z USE ZONE DEVELOPMENT NO PZZQ[9 -()-Z27 PLAN CHECK FEES $ 1 07 -9nty.