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Home My WebLink AboutX2021-3103 - Permit Application (2)-� �� Print Form W eetar Buiolar Permit Ap�n^l�ica ion fn F_ Comm'I ]-Residential) x City of Newport Beach - B ilding Division \ (-G I NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL k�/�/'" 'j?jC@uilding [ Gradingrainage �(,Elec )<kech IV,um CuvdCut Cu dFill Project Address (Not mailing address) F_ Flood F— Fire f— Liq 7_ Landslide N/A Floor Suite No ZCo 1't l iJ r�.. Description of Work ' gcvUse Const Type # Stories # Units (if Res) S�sUc-�c,c�l New/Add SF� Remodel SF f --- /New/Add! luation$ �. Material/Labor y 0 0 OWNER'S NAME Last.._.. First. Owner's Address Owner's E-mail Address City bVQ T- r1 State f 7W-_.-- Zip ��., Telephon 4 4 APPLICANT'S NAME Last I illv, l Firsts Applicant's Address Applicant's E-mail Address (le) ' Y/r*vv ..'�-..... 1 1 p �xC---.... (�%�,SL9 l.'C�©e'�4 i✓f3 cityC r�c�.�-s�� State �l Zip ARCHITECT/DESIGNER'S NAME L`( C First y�� ilicNo fAdtdress -v Architect/De er's Address 4y Architect/Designer's E-mail City State F07 Zi j Telephone 6... ®s _ A �✓�i�4C.. ENGINEER'S NAME Last i First oL.1,D c. No.�� d Engineer's Address Engineer's E-mail Address f. - City State F Zip- Telephonew CONTRACTOR'S NAME/COMPANY Lic. No. F. ClassF Contractor's Address Contractor's E-mail Address City State F Zip F-----.-----, TelephoneF�W SETBACKS REAR c SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. ' + USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ 7