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for Contbo Building & solar Permit Application
City o1i Newport Beach - Building Division
VOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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APPLICANT'S NAME Last
pplicant's Address
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ARCHITECT/DESIGNER'S NAME
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Owner's E-mail Address
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Zip I S i GL
First
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Last Lic No.
I First
Architect/Designer's Address
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Architect/Designer's E-mail Address
Telephone
zip —j E
Lic No i
ENGINEER'S NAME Last First -----
Engineer's E-mail Address
Engineer's Address:
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' State Zip I Telephone
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\ ' CONTRACTOR'S NAME/COMPANY Contractor's E-mail Add
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SETBACKS FRONT PERMIT NO.
,KS REAR
S / / �'P}LAN CHECK NO.
SETBACKS RIGHT
`$ LEFT DEVELOPMENT NO �/��L.Py-�N CHECK FEES $ Q,i'' tGli
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CITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
949-644-3200
PLAN PROCESSING REQUEST
ADDRESS: (�7zc
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DESCRIPTION:
C-R ... S( IU- �1K11-II�J�., i1 G�
In /' I c Aq/,-/ioiJ REV ✓I� Gr i
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KAN CK #: 0�T Z�
❑ NEW ( OTC I APC / SUBMIT)
❑ RF UBMIT ( recheck/ process RFI
) T�2
{—'
2
pc hrs. _{�-7
EVISION (delta # -')
# of PAGES (plans 0 8% x11 )
C-
BLDG STATUS: AP I PA I C PP
EMP STATUS: AP/PAICOIPP
DEPT/DIV REVIEW NEEDED: (circle requi 1
PLNG PW EMP HARBOR FIRE GRADING
Engineer: C <S, date:
Contact Name & #:
Forms\PlanPmcessingRequest