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F-r Comm'I Residential City of Newport
FBuilding r Grading rDrainage r Elec rMech r Plum Cu Yd Cut Cu Yd Fill l
Project Address (Not mailing address) r Flood r Fire r Liq r Landslide rN/A Floor Suite No
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Description of Work
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Use Const Type F
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# StoriesF #Units (if Res)
Valuation,j/�j ��,.T
Material/Lab
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New/AddSF� Remodel SF� Garage/New/Add
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OWNER'S NAME Last v Sl First
Owner's Address Owner's E-mail Address
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City N ii` \ f � � ) C �7l State Zip �G L '� Telephone ) ) 7 .� / L%
APPLICANT'S NAM Last First
Applicant's Address Applicant's E-mail Address
city T p- / ,' / State EM Zip � L� C'� Telephone /Z7
ARCHITECT/DESIGNER'S NAME Last First F Lit. No. I
Architect/Designer's Address t " v "�Architect/Designer's E-mail Address
City State Zip F Telephone
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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--TT- (( P),j�J� �(���Lic.No. 1(�"'/��J Class—��
Contractor's Address Contractor's E-mail Address
LUC 10, �( L�) CCE 6- CT(-<(;4�
City , State — Zip � / v Telephone (�, f'�_Gr,
SETBACKS REAR SETBACKS FRONT PERMIT NO. ` 4 Ztc L l ^ bC)f7 S
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. (� (� y - (qZ2
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $