HomeMy WebLinkAboutXR2022-3274 - Permit Application (5)L Print Form �Wlfurkshewut for Combo Buflfflng - J , & So�Gar Permit Application
Comm'I F_ Residential City of Newport Beach - Building Division Xg Raw. " ?,
NOTE: PLAN CHECK FEES DUE AT TIME nF.ql IRNAITT.41 (I'li, - gzk�llli
fC,-B-uilding Ft— Grading f—Drainage F_ Elec F_ Mech Plum Cu Yd Cut[_Cu Yd Fill
Project Address (Not mailing address) r— Flood Fire f7 Liq F_ Landslide [_N/A Floor Suite No
-2_2'
... . . ... ......... ........ ...................... F F
Description of Work 7-el211,71d,,
r Use PE�/ G�'ConstType FZ/_—/2:)
AA,0 %_7 4/7
#Stories'j_-7 #Units (if Res)7
.-_-
612-9 A N 0 /0V 5 1/ AC /2+ 6L P6oZ_
New/Add SF R_ejpod6l SF SIC Garage/New/Add
Valuation $ opt
Material/Labor I"
OWNER'S NAME Last First
-------------
Owner's Address Owner's E-m_WL ss
.. .. .... .........
City State 77 ZiPF- Telephonel
APPLICANT'S NAME Last (o, A ,< First
Applicant's Address Applicant's E-mail Address
IV6%_
City I 15A71-A-V 14 A: LA -;IJ State zip Telephone 17-
ARCHITECT/DESIGNER'S NAME Last ?Alv 1e2-I --1rst 2 AI-- A.. 1 _D�XL i c. N<_1r__z-
Architect/Designer's Address Arch itect/Designer's E-mail Address
Ae. ............
City t Telephone
---- ------- ----- - ----- a te_�_ Z] �p
ENGINEER'S NAME Last First F Lic. No.
Engineer's Address Engineer's E-mail Address
City State Zip Telephone
F
CONTRACTOR'S NAME/COMPANY Lic. No. F-Class
Contractor's Address Contractor's E-mail Address
.. . ... ... ............ ..... ...... ... .... . ...........
City State zip Telephone F
SETBACKS REAR SETBACKS FRONT PERMIT NO. x F-1,0 U, -%2.14
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO ____ PLAN CHECK FEES $