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VNorksheet for Combo Building & Solar Permit Application (:�JR4�Comm'IResidential City of Newport Beach -Building Division�
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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ractor's Address
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SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. '6 (6
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $
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X2017 X135
Worksheet for Combo Building & Solar Permit Application =�"'�
)- Comm'I r Residential City of Newport Beach - Building Division aG ro.
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL o
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Project Address (Not mailing address) C Flood f- Fire [7 Liq F_ Landslide f N/A Floor Suite No
Description of Work
Use I Const Type �—
# Stories # Units (if Res) -
IValuation
New Add SF 17 Remodel SF 7
Garag e/New/Add �—
Material/Labor
OWNER'S NAME Last
First I
Owner's Address
Owner's E-mail Address
�—
Ciry _ _ _ State ' _ _
Zip Telephone
APPLICANT'S NAME Last
First
Applicants Address
Applicant's E-mail Address
City State
Zip Telephone
ARCHITECT/DESIGNER'S NAME Last I
First Lic. No.
Architect/Designers Address
Architect/Designer's E-mail Address
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City State
Zip IF Telephone,
ENGINEER'S NAME Last
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Engineer's Address
Engineer's E-mail Address
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City State i
Zip Tele � phone—
CONTRACTOR'S NAME/COMPANY
Lic. No. �- Class
Contractor's Address
Contractor's E-mail Address
City State F
I
Zip Telephone,I—
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. a
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $