HomeMy WebLinkAboutX2020-0559 - Permit Applicationv111Y IT NewportNNrrtaailon .g-cp
NOTE: P11 LAN CHECK EES DUE Building
IME OF SUBMITTAL
on
r,1Building [ Grading 4
[;Drainage [JElec ( Mech (�'--- "'
Project Address [ 1 plum a;vd call
(Not mailing address) [ Flood Fire Cu Yd Fill
❑ Lig r� Landslide MN/A , Floor
Suite No
Description OOf� Work --- i -I F-7-71
Use � Const Type
# Stories
�s # Units (if Res)
New/Add SF- _ - - -
_ Remodel SF�-
i _ I Garage/New/Add i Valuation $
OWNER'S NAME ` _ Material/Labor' -
Last { _
Owner's Address First
- - Owner's E-mail Address _ --
City-
' State '- - -- i
Zip Telephone/fir J
:APPLICANT'S NAME ' _ f "%
Last yyyy'� - l
ApPlicanfs Address - - --- _ First I
Applicant's E-mail Address _---- - - - J
city
State — ;
—� Zip Telephone - —
ARCHITECT/DESIGNER'S NAME _
Last
Architect/Designer's Address First _ ` -
_ Lic. No. �-
�__ ArchttecVDesigner'sE-mail Address
_'
City
State
Zip �7'6, Telephone let
ENGINEER'S NAME i
Last
Engineer's Address - - - -_ _ First V- , F
pp J Lic. N0
Engineer's E-mail Address
- - , ' J�„
State L, _ Zip
Telephone
CONTRACTOR'S NAME/COMPANY
Contractor's Address Lic. No. �--i
Classr__7
Contractor's E-mail Address
City �_. ---- ---------- � -- -- - _
State
��� — - ---
: - t Zip f.-_ - 1i Telephone
-
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT
SETBACKS RIGHT -- PERMIT NO. '7
USE ZONE PLAN CHECK NO. i
DEVELOPMENT NO
PLAN CHECK FEES $ ;