HomeMy WebLinkAboutXC2022-1992 - Permit Applicationr?nr,it:�rm Workshek for Combo Building & ouiar Permit App'9iCation U� =
F-7 Comm'I F_ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Building [Grading rDrainage [Elec Mech Plum cuvdCut F cuYdFfll�
Project Address (Not mailing address) C Flood F Fire r- Liq (— Landslide CN/A Floor Suite No
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Description of Work
Use F_ ConstType
NOtj- 1 IJCrt9R'.QL ('c'JSNtt" 11G 16.1t71z- f�1�I,OC.��L
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# Stories # Units (if Res)F
P.EPL ACr EXrsTlt`k (!; 01Z-<V/d L_ L-- V_z>0A lovT LLKt=1n.t�{�trlh
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Material/Labor 37) �"
New/Add SF Remodel SF Z ).9 2 Garage/New/Add �—
OWNER'S NAME Last First K
Owners Address Owner's E-mail Address
City State �' `t Zip Telephone
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APPLICANT'S NAME 'J 1 Last First
Applicant's Address Applicant's E-mail Address
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City rJ�j l - - State e� ZiP V�Zf�— Telephone
ARCHITECT/DESIGNER'S NAME Last i��g%�� _- First � ti�L- Lic. No.
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Architect/Designees Address Architect/Designer's E-mail Address
I-_4__6 A v1Ajj L - -- - -- L k_��ZK�J� A c .Cotes
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City TIXs?IiJ... State �— ZIP -g2720) Telephone ZS_E5,j
ENGINEER'S NAME Last First F_ Lic. No.�--
Engineer's �`hl'�
9 Engineer's E-mail Address
City State Zip �— Telephoner
CONTRACTOR'S NAME/COMPANY 1� e2OM5Tf, V, -C t0$4 Lic. No. 7(I �%�J Class FE
Contractor's Address Contractor's E-mail Address
CNfZts co t`�r`1 12 —e�ttY�T�GTtC�tJJ • C�r`I
City -1 L)S T I T State Ci4 Zip Cj 7� Telephone - 1-1-,2S t - _127z�
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SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $