HomeMy WebLinkAboutXR2024-0366 - Permit Application%Comm'I "esidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Pfuilding F_ Grading F-Drainage F_ Elec r Mech
r Plum Cu vd Cut Cu Yd Fill
Project Address (Not mailing address) I_ Flood
F_ Fire j_ Liq r Landslide (-N/A Floor Suite No
c-,x e/x
Descripti n of Work �tIA Iz_ i/,A M Aiv f �rrSFO/tAT/ o/V
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Use/K-" G{L�ConstType I " �J
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C�nC_� ��
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f /JP/�.
# Stories # Units (if Res)rJ
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%/Z- Gf/Ac-L-�� iQ t O olG/TUGS / f/-��/tAU �'USVC. i65 i
c�TO
i2
New/Add SFF� R aweL+SIF 5,0= Garage/New/Add
r—
Valuation $
Material/Labor / Or`
OWNER'S NAME Last ��//N GQ First
Owner's Address
Owner's E-mail
City State �—
Zip r Telephoned
APPLICANT'S NAME Last
First Alv
Applicant's Address
Applicant's E-mail Address
City IbAL 8 ,�A State �L �q
Zip Telephone
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ARCHITECT/DESIGNER'S NAME Last AAA First L
;// C. No
17A/L(0/ ic2�L2LS
Architect/Designer's Address
Architect/Designer's E-mail Address
City State
Ic
Telephone
ENGINEER'S NAME Last
First Lic. No f —
Engineer's Address
Engineer's E-mail Address
City State
Zip L TelephoneF
CONTRACTOR'S NAMEXOMPANY
Lic No. r--- Class r_
Contractor's Address
Contractor's E-mail Address
City State
Zip Telephonef
SETBACKS REAR SETBACKS FRONT
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PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
'fR.
PLAN CHECK NO. a{,{/�,� •�
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $