HomeMy WebLinkAboutX2021-0422 - Permit Application (2)rrv111%a11CM 11U1 %.Ur1rIUU CuuUlll9 or OUlar r'ermn Application
F_ Comm'[ r Residential City of Newport Beach - Building Division -0 Zn
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMI AL. C•
[-Building r Grading [-Drainage r Elec
Project Address (Not mailing addrel
of Work
Mach r Plum c, Yd
F.- Flood r Firer Liq r Landslide
New/AddSFE77777 Remodel SFF7 Garage/New/Add
OWNER'S NAME Last I First
Owner's Address
City �— State
APPLICANT'S NAME Last
Applicant's Address
City State
Cu Yd Fill
f
r A Floor
Suite No
177
F_7
Use F7 Const Type F
# StoriesF—# Units (if Res)F_
-
Valuation $
Material/Labor
Owner's E-mail Address
Zip
First
Applicant's E-mail Address
- - -
Zip �— Telephone[..,--,----
ARCHITECT/DESIGNER'S
elephoner
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address
... ...... ---- --
city
City State F
Architect/Designer's E-mail Address
Zip [ — TelephoneF
ENGINEER'S NAME Last ' First Lic. No.1—
Engineer's Address
........
City I State F
Engineer's E-mail Address
Zip Telephone
SETBACKS REAR
SETBACKS LEFT
USE ZONE
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEES $
H