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Worksheet for Combo Building & Solar Permit Application
F Comm'I residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
IvBuilding F, Grading F -Drainage Elec r!Mech F-, Plum CuvdCut Cu Yd Fill
Project Address (Not mailing address) C Flood Fire [ Liq [ LandslideN/A Floor Suite No
Description of Work
UVINOOWS I eAVlC '0 Ob% U-LCt—
Use f_Const Type I J
# Stories # Units (if Res)
i
�g Valuation$
New/Add SF v_—., RemodelSFl Gara a/New/Addl Material/Labor
OWNER'S NAME Last
Owner's Address -
51-
City t��LuP01'fj' -'i� State
APPLICANT'S NAME Last
Applicant's Address
City _ State 177
First
Owner's E-mail Address
Zip �Q I Telephone ?�IJr) 7,)-1 -
First
Applicant's E-mail Address
Zip Telephoned
ARCHITECT/DESIGNER'S NAME Last First Lic. No. [E -S-01
Architect/Designer's Address
Gloz�1
_-
city _ y� mo,�46( state L Z)
Architect/Designer's E-mail Address
coM
ZipTelephone
Rum-gqa.33$cy�o
ENGINEER'S NAME Oast flmay_, First 1y1 Lic.No.rj�
Engineer's Address
City I & WN &IwVt-, J State
CONTRACTOR'S NAME/COMPANY
S86 CONS 7-9uCTion/
Contractor's Address
----.---------- -.- /I --.-SNOvJ&&W]
Engineer's E-mail Address
-
Zip 01� I Telephone 14$!57 .$5
-
City State I I-- ZipL-ee� pTnE
i2ynv (2 G .9 Z6o /v a, SYt2 g
SETBACKS REAR SETBACKS FRONT PERMIT NO. �
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $