HomeMy WebLinkAboutX2019-1119 - Permit Application (3)v YA(orkghp
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aComm'I �( Residential City of Newport Beach -Building Division �
�C� NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMIT
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OWNER'SNAME Last: SG C�L�
First Bur 0-rtr7'. D;OJ't'e,
Owner's Address
Owner's E-mail Address
211 & La al r r�e__ �-
City /1100 p or- aeo-Qk State CA
Zip F Telephone q L( 9_ iJOO _ 9 W
APPLICANT'S NAME Last'Richart _
First iJazon
Applicant's Address
Applicant's E-mail Address
1041 W. 18th St, (A106)
Jason@dchartdesign.net
City Costa Mesa State CA
Zip 92627 Telephone 1949-42� 2-9191
ARCHITECT/DESIGNER'S NAME Last Richart First Jason Lic. No.
Architect/Designers Address
Architect/Designees E-mail Address
1041 W. 18th St, (A106)
Jason@richartdesign.net
City (Costa Mesa State !CA
Zip t92627 Telephonej949-422-9191
ENGINEER'S NAME Last Gkoa I C� n r First Lic. No.1609�)7
Engineer's Address
Engineer's E-mail Address
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City I Lor >e",k State FA---
Zip r 9�o--g•O� Telephone�2�j�j
CONTRACTOR'S NAME/COMPANY i i/ip , b
V
t ram,,, / INL• Lic. No. 74 Classi
Contractors .Address
Contractors E-mail Address
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City u rl a. lei tq k e State I `"
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ZipFq�:br Telephone a w-1-: S, q-77
SETBACKS REAP. SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
'PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $