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City of Newport Beach - Building Division
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Description of Work
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APPLICANTS NAME Last First I
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ARCHITECT/DESIGNER'S NAME Last i mtos l N First Lic. No. G .19-7I
Architect/Designer's Address E-mail Address
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Lic. No. �— Class
CONTRACTOR'S NAME/COMPANY Ap�
Contractor's Address Contractor's E-mail Address
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City { State �— Zip Telephoner
SETBACKS REAR SETBACKS FRONT PERMIT NO. , 0
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK O.
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