HomeMy WebLinkAboutX2019-0965 - Permit ApplicationPrint Form Worksheet for Combo Building & polar permit Application
K°%00Lit ®6( to6 City of Newport Beach - Ig
Divisionr- Comml r Residential NOTE: PLAN CHECK FEES DUE AT TIME
OF SUBMITTAL
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Desc ' tion of WorkUse
oU onst Type',
�G 1{k Vv� Cn C `v' Lt/�
# Stories # Units (if Res)
Valuation $
Material/Labor[2j
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New/Add SFF— Remodel SFF ; ,- Garage/New/Add
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OWNER'S NAME I ast I Qs��✓SGA� W� First 41 Lf
Owner's Address Owner's E-mail Address
City ' nn State CA I �l U p
ZIP I "l 'Uto Tele hone (/'
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APPLICANT'S NAME Last Richart _ First Jason
Applicant's Address Applicant's E-mail Address
1041 W. 18th St, (A106) Jason@richartdesign.net
City Costa Mesa State CA :P 92^v27 Telephone 949 422-9191
ARCHITECT/DESIGNER'S NAME Last Richart �, First rJasonLic. No. I W'
ArchitectlDesigner's Address ArchitecttDesigner's E-mail Address
1041 W. 18th St, (Aloe) Jason@richartdesign.net
City Costa Mesa State CA Zip 92627 Telephone 949-422-9191
ENGINEER'S NAME Last First F_ Lit. NoF_
Engineer's Address Engineer's E-mail Address
City tate Zip Telephone
CONTRACTOR'S NAME/COMPANY �04 3 L� ILS Lic. No. �$ Class
Contractor's Address Contractor's E-mail Address
031 SRUJtJCtE 'ZD fA AM(3LAAF-CaNS�'QUC_t-% hl (34MA14., CSW\
City W ct�\NST E 6L State G,t�, Zip F4"P4 Telephone ci Li q 5 y 7-4 2-2,
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SETBACKS REAR SETBACKS FRONT PERMIT NO. di t -1 ' 061 (P
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 0&&PS-2_0 19
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $