HomeMy WebLinkAboutXR2023-1735 - Permit Applicationomm'I 1 esldentWorksheetN�oECombo Building & SMEa�rFP Permit
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ial City of Newport
: PLAN CHECK
ES
UE AT
Print Form � Rr
F"uilding r Grading
rDrainage r Elec r Mech r Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood r Fire r Liq r Landslide rN/A Floor Suite No
Description of Work Z) 2j�. : /L.,d ",v
Use��ConstType i f}
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4trc� Js o % L�CC x 6 �3
# Stories �f" # Units (if Res)
� N `Z/44T�/Z
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5QA-1 �1 Cr—, ` �r'S(/C l� �/C7U �S /�
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Valuation $ ) 7i / Gz
Material/Labor /% "�
New/Add SF F—
2f5 j�
Re I Z S� Garage/New/Add �—
OWNER'S NAME
p /
Last /ofCC First
Owner's Address
Owner's E-mail Address
City
State �— � Zip TelephoneF_
APPLICANT'S NAME
Last /z-(/ /j,C, First
Applicant's Address
Applicant's E-mail Address
776 6,41Ovf[ /dy'Gf A7 z� � � /CC'�C •�C7��
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City /� �JC,4 ;SLAX/G� State �L_ N Zip 94 - Z Telephone
ARCHITECT/DESIGNER'S NAME Lastj/PAA First ; 6A Lic. No —ZI-225
/
Architect/Designer's Address
Architect/Designers E-mail Address
r�, Az
A 4
City F_—
State F__ Zip F_ Telephoned
ENGINEER'S NAME
Last First F Lic. No.F-
Engineer's Address
Engineer's E-mail Address
City
State F_ Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY rcn Lic No. / C�11j Class
C/
Contractors Address
Contractors E-mail Address
lt( 8 /(w/l
7F `7
'ty L0-�ij-a-C
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State F—Zip �(b6 Telephone
SETBACKS REAR
SETBACKS FRONT PERMIT NO. - ) • �1
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. POW 22
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $