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Workslyeeet for Combo Building & Solar Permit Application
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City of Newport Beach - Building Division _
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Description of Work
Use Const Type
# Stories # Units (if Res)F—
New/Add SF�—
Valuation $
Remodel SF�— Garage/New/Add �� Material/tabor � J Wi
OWNER'S NAME Last I `�{,,,,,,, j.t yc,,.ft � 4 ,,5 - First I
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Owner's Address
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E-mail Address V
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State / •' F Zip I q j ��4a Telephone - Q
APPLICANT'S NAME Last��7First I
Applicants Address
� Applicants E-mail Address
City
State Zip Telephone 7(q6b -VR
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ARCHITECT/DESIGNER'S NAME Last First �V Lic. No.
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.A rchitecUDesigners Address
Architect/Designees E-mail Address
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F 2�Telephonnel
City
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NGINEER'S NAME
Last First I Lic. No.�—
Engineer's Address
Engineer's E-mail Address
City�1 ,'
State Zip �— Telephone
CONTRACTOR COMPANY 1 s F�
' Lic. No. �ClassContractors
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SETS REAR
SETBACKS FRONT PERMIT NO. 2fj `�
CHECK NO
SETBACKS LEFT
SETBACKS RIGHT APLAN
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DEVELOPMENT NO