HomeMy WebLinkAboutXR2023-1145 - Permit ApplicationPrint Form
IPermitWOCkSheet oreCo ityo Building & SingarApplication
Comm'I Residential Newport
Beach
Division
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Project Address (Not mailing address) C Flood F Fire F_ Liq Landslide rN/A Floor Suite No
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Description of Work /NSi//k (L) /'���5 ��� 3 /�1�
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Use Co",tiISul,
# Stories # Units (if Resf
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Valuation $ ¢
Material/Cabo I � i 149' GI9
New/Add SF ® Remodel SF ri�F} Garage/New/Add h.l �
OWNER'S NAME Last ` �2_ First
Owner's Address Owner's E-mail Address
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City NfvSPoS�( d�W3C11 _ State Zip c7j2� Telephone
APPLICANT'S NAME LastI -A First t)5-ri,,A
Applicant's Address Applicant's E-mail Address
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City h1Fu1 t &ijtN _ _ State Zip ` z_i 60 Telephone
ARCHITECT/DESIGNER'S NAME Last 0 L_ 5'0,-,1 First FT(v I f] Lic. No. C n/i24
Architect/Designer's Address Architect/Designer's E-mail Address
City State C Zip I I1(o I '�lj Telephone (q,�) 450- Oo9 3
ENGINEER'S NAME Last �F t t Nit First a Lic. No. C�-9v ►o(
Engineer's Address Engineer's E-mail Address
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City Ac,�tiIR NILLState F CrA Zip 92fP53 TelephoneF(94 °IS+--�-Zg4
CONTRACTOR'S NAME/COMPANY :: L Lic. No. E ;O Jet Class
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Contractor's Address Contractor's E-mail Address
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City I �&jfog: F>iAC."_ State Ct,, Zip `IZ-.l (E' C Telephone '`9," Z�(
SETBACKS REAR SETBACKS FRONT PERMIT NO. x
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
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