HomeMy WebLinkAboutPV2020-103 - Permit ApplicationF- Comm'I �esiCiYnii�f �U 3 City of Newport Beach -Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
wilding Grading f Drainage (-Elec F_Mech F- Plum Cu Yd Cut F Cu Yd Fill
Project Address (Not mailing address) F_ Flood r Fire r, Liq r Landslide FN/A FloorCSuite No
sa,�fi n� �.ur-�ra,�e.-. E,m� �P.� �'t�r; �I2cP Z5F_r�_
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Description of Work
Use F—ConstType �
15.3 k w '4S ov�.a Q/S
2- % ✓LV � I�5 �j � � Cil t e S
# Stories # Units (if Res)[_
S Ll 5,7 4 I�xi 51-vwJ
Z{D D c,�p ✓+A"r P00
I _
New/Add SFF—, Remodel SFGarage/New/Add F --M'
Valuation
Material/Labor -I
OWNER'S NAME Last I
Qp,(kec RLs<4-e� First
Owner's Address
Owner's E-mail Address
City ��r VJ. Mor o r
State I ZIP Cj2 zs- Telephone F7$q 723 /SOD
APPLICANT'S NAME Last
V✓I-P.v44-5 First
Applicant's Address/
Applicant's E-mail Address
City `�s4t, VVLQA
Statec; Zip c1 1.27 Telephone(q�q 32� A, Z_
ARCHITECT/DESIGNER'S NAME
Last F First I Lic. No.
Architect/Designer's Address
ArchitecUDesigner's E-mail Address
City
State F Zip F_ Telephoned
ENGINEER'S NAME Last
�p, "_ � r First Lic. No.F—';
J
Engineer's Address
Engineer's E-mail Address
_20271 Lr'y1.�hai,Csz L✓t.
City H. (3.
w; State F — ZiP O/2ryp Telephone 4t9 ZSS 5 -/DL{
CONTRACTOR'S NAME/COMPANY
r �ji C So Loves Lic. No. 1029" 7 Class F -13
Contractor's Address
Contractor's E-mail Address
City Cv s-�44,,11, .....
State I CA Zip c2_& 2-7 TelephoneF Dai tl/ii -39,3 3......
SETBACKS REAR
SETBACKS FRONT PERMIT NOXV W' j 911
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO . PLAN CHECK FEES $