HomeMy WebLinkAboutX2021-3207 - Permit ApplicationF Comm'I [Residential
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City of Newport Beach - Building Division �;'LOZt • �j20 �—
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"NOTE: PLAN CHECK FEES DUE AT TIME nF RI IRnnlrrAr c." .._�
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Project Address (Not mailing address) F7 Flood j- Fire r Liq r Landslide [-N/A Floor Suite No
Description of Work
UseSFS Const Type v$
Neo dt� veer pf s�dP�, sl►� r� sF�;
3 # Stories # Units (if Res)F
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New/Add SF[___Remodel SF ara e/New/Add Material/Labor
OWNER'S NAME Last First 1. b 4111111L
Owner's Address Owner's E-mail Address
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City �iQp I Qti�}! �e Lr,(,� State �— Zip Telephone
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APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
City � State �— Zip F_ Telephone—
ARCHITECT/DESIGNER'S NAME LastFirst S
� Lic. No.
ArchitecflDesigner's Address Architect/Designer's E-mail Address
U081 Ol i c% Cakinonerile
City �(���� e�N State Zip TelephoneC(Gj ClsCp�jf
ENGINEER'S NAME Last h J1°l.C..ar' First Lic. Nof—
Engineer's Address Engineer's E-mail Address
City State F Zip Telephone
CONTRACTOR'S NAME/COMPANY Lic. No. F Class
Contractor's Address Contractor's E-mail Address
City �— State F Zip �— Telephone
SETBACKS REAR SETBACKS FRONT �� a PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 2 e — ZU A
USE ZONE'' DEVELOPMENT NO PLAN CHECK FEES $