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Print Form Worksheet for Combo Building & Solar Permit Application
F- Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
FX_ Building F_ Grading r -Drainage rElec r.Mech
nPlum Cu yd cut l0.
Cu yd rill 10
Project Address (Not mailing address) r Flood
r Fire r Liq FLandslide
1 -N/A Floor
Suite No
2800 Bayview Drive
F_
Use R3/U Const Type V_B
# StoriesF #Units(ifRes)FT
',
Valuation $
New/Add SF I Remodel SF 238 Garage/New/Add 26 Material/Labor 251
000
OWNER'S NAME Last (Bogner First (Charles
Owner's Address Owner's E-mail Address
2800 Bayview Drive mechazz33@sboglobal.net
City Newport Beach State Ca Zip 82625 Telephone 714-225-4008
APPLICANT'S NAME Last
Applicant's Address
2800 Bayview Drive
city Newport Beach State Ca.
I First lCharles
Applicant's E-mail Address
imechazz33@sbcglobal.net
Zip 92625 Telephone 714-225-4008
ARCHITECT/DESIGNER'S NAME Last Oslin First Brian Lic. No.F__
Architect/Designer's Address
8621 Bellmead Drive
City Huntington Beach State Ca.
Architect/Designees E-mail Address
Foslin.desig n@gmail.com
Zip 92646 Telephone 714-962-1148
ENGINEER'S NAME Last Weber First Stephen Lic. No. 40001
Engineer's Address
39506 N. Daisy Mountain Drive #122-263
City Anthem State f
Engineer's E-mail Address
liglengrl@live.com
Zip 85086 Telephone623-551-7024
CONTRACTOR'S NAME/COMPANY Owner Lic. No.F Class
Contractor's Address Contractor's E-mail Address
cityI
SETBACKS REAR
SETBACKS LEFT
USE ZONE
State F_ Zip
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
Telephone_;
PERMITNO.
T
PLAN CHECK NO.
PLAN CHECK FEES $