HomeMy WebLinkAboutX2015-2206 - Permit Application (4)WOrkshsstl for Combo BPAUng & SoW PermKr AppHcaUon
r'.IMT
-Cornrn'l Residential CK City of Newport Beach - Building Division _A�0 6
NOTE: PLAN CHEFEES DUE AT TIME OF SUBMITTAL X�015
[` Building I— Grading I —Drainage #%Mec ,F Mech V-Plurn Cu Yd Cut F Cu Yd Fill I
Project Address (Not maillilng address) Flood F_ Fire f_! Liq r Landslide Floor Suite No
Description of Work
'Call
se onst Type
f,N <
e
7-7t (Ze- I ofe? `fit 5-t uc
# Storied # Units (if Res)
Valuation $
Material/Labor
I�F
New/Add SF1 Remodel SF New/Add
7 ) �1
FOW arage/---------------------------------
OWNER'S NAME Lastl lz',hc� First �:� F / ir
Owner's Address Owner's E-mail Address
& h
City 7,nT/17" -
State i Zip Telephone[*/-�' fZ4-ff f 77
APPLICANT'S NAME Last First
I#; X� �m - kv
Applicant's Address Applicant's E-mail Address
d L) J
City J,! IL State zip Telephone
CT J V�Y. KJ /7�
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
T. —vL-4 —5 - +—e-
City,State zip TelephoneV. _03
ENGINEER'S NAME Last First Lic. No.
I , x- FE ru Z 7e- 7IC 03 145k, 1
Engineer's Address Engineer's E-mail Address
City State zi96 Telephon'e /0 L(
Fe,47 p
CONTRACTOR'S NAME/COMPANY Lic. No. Class
iZ �j' 7 1
Contractor's Address Contractor's E-mail Address
Wgo ,tj� 5- -
hone
City State Zip Telep7�
55 1-7
TBACKS REAR SETBACKS FRONT PERMIT NO, L�, Lo
SACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
'ONE DEVELOPMENT NO PLAN CHECK FEES $
la,