HomeMy WebLinkAboutXR2023-0300 - Permit Application1. P ntl ....... I Worksheet for Cornbo.Bui[ding & Sciar Permit Application
f_mm'I r Residential City of Newport Beach - Building Division
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f—Building F_ Grading rDrainage r Elec r Mech F— Plum Cu Yd Cutl Cu Yd Fill
Project Address (Not mailing address) [ Flood r Fire F_ Liq r- Landslide rN/A Floc
31I +LrA (s+ '7 26 c) F
Description of Work
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Use Co
le $" r7 "luA'L- Cc.c ,A-G � tv/�/l nl
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Stories
New/AddSFF— Remodel SFF— Garage/New/Add—
Valuation $ C
Material/Labor C
OWNER'S NAME Last �/ / A
First
Owner's Address
Owner's E-mail Address
City _ A( iq State I E-'f,-7_' Zip ' 2 , /a c�`
% �p Telephone
J � S � J
APPLICANT'S NAME Last —_ First
Applicant's Address Applicant's E-mail Address
C'c
City State G / Zip Z�(e Telephone
J7_z _',2/ J
ARCHITECT/DESIGNER'S NAME Last 5
-_ 7r First �(� QL/1 r
_ (— Lic. No.
Architect Designer's Address Architect/Designer's E-mail Address
of S
City State �— zip[,TelephoneF�
ENGINEER'S NAME Last First
Lic. No
Engineer's Address Engineer's E-mail Address
City F® State Zip �— Telephoned ----
CONTRACTOR'S NAME/COMPANY � /
G! LU °mot e.1271�- l L p is L Lic. No.
Contractor's Address Contractor's E-mail Address
City State F_ Zip F� Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO. 2 ��C
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
ir Suite No
Est Type
Units (if Res)
-s /
7,2-t
,lass Faip C_
5