HomeMy WebLinkAboutXR2022-3010 - Permit ApplicationF_[omm1 F_Residentia| City ofNewport Beach ' Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F—Building f— Grading f—Drainage F_ Elec F_ Mech Plum Cu Yd Cut F_ Cu Yd Fill F_
Project ,Address (Not MaIJUT19 address) [_ Flood f— Fire f— Liq r— Landslide F_N/A
Floor
Description of Work
_ I —
Suite No
Use F [urst Type
#Stohed # Units (if
OWNER'S NAME
Last First
Owner's Address Owner's E-mail Address
City State Zip
F Telephone[ �14 (4 1
ENGINEER'S NAME Last /
[ First | L(cNo�
--- -------- ------- �------'—__--_ l�Engineer's Address Engineer's E-mail Address
City | State |_ zip | Telehonel
____�-------
Contractor's Address Contractor's E-mail Address
city State zip Telephone 46 1—
GETBACKSREAR
SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE
DEVELOPMENT NO
PERMIT NO.XR?02?-301V)(q1Q1Z--
PLAN CHECK NO. rCZ022- Z97Y
PLAN CHECK FEES $