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PnntForm Worksheet for Combo Building & Solar Permit Application 0"DCComm'I C Residential City of Newport Beach - Building DivisionNOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[!Building [Grading F -Drainage ❑Elec _'Mech F-1 Plum Cu Yd cut Cu Yd FIJI
Project Address (Not mailing address) G Flood ❑ Fire F Liq ❑ Landslide ❑N/A Floor Suite No
850 San Clemente Drive, Newport Beach, CA 92660
Description of Work
Use Mixed', Const Type
Construction of new Site Retaining Walls
# Stories; # Units (if Res) 99 1
Valuation $
F165,163.00New/Add
Material/Labo
SF�Remodel SFj
Garage/New/Add
OWNER'S NAME Last Kaufman
First IMatthew
Owner's Address
Owner's E-mail Address
1 MacArthur Place, Suite 300 _ __
mbk@nexusd.com
City Santa Ana State CA _'' Zip 82707 Telephone 714.546.5600x211
APPLICANT'S NAME Last Eres First Robert
Applicant's Address
Applicant's E-mail Address
1 MacArthur Place, Suite 300
rwe@nexusd.com
City Santa Ana State CA
Zip 92707 Telephone 714.546.5600x220
ARCHITECT/DESIGNER'S NAME Last Harrier _ _— _ First on Lic. No. C-21353
Architect/Designer's Address
Architect/Designees E-mail Address
HKS Architects: 539 Bryant Street, Suite 100
dharrier@hksinc.com
City San Francisco State CA
Zip 94107 Telephone 15.356.3800
ENGINEER'S NAME Last andervis
First Jacob': Lic. No. 6301
Engineer's Address
Engineer's E-mail Address
ait Engineering: 701 N. Parkcenter Dr.
acobv@tait.com _
City Santa Ana State CA
-- — -- - -
Zip 92705 Telephone 714.560 8200
CONTRACTOR'S NAME/COMPANY BID
Lic,No. lasso
Contractor's Address
Contractor's E-mail Address
City State
Zip Telephones
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO,
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $
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