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Pr;nt Form Worksheet for Combo Building & Solar Per
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City of Newport Beach - Building Division Gao
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Comm'I F_ Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) : Flood F- Fire Liq f- Landslide [-N/A Floor Suite No
Description of Work Use F Const Type
# Stories' # Units (if Resf _
Valuation $
New/Add SF
Remodel SF I Garage/New/Add Material/Labor
OWNER'S NAME Last First
Owners Address Owner's E-mail Address
State ��. Zips Telephones
City...
APPLICANT'S NAME Last
Applicant's Address
City State F_ Zip
ARCHITECT/DESIGNER'S NAME Last
Architect/Designer's Address
Firsts
Applicant's E-mail Address
Telephanes�
First
Architect/Designees E-mail Address
City
State F_ Zip Telephonel
ENGINEER'S NAME Last Firsts�v
Engineer's Addre. Engineer's E-mail Address
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City
State Zip Telephone
Lic. No. F_
Lic. No.F_
CONTRACTOR'S NAME/COMPANY
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Contractor's E-mail Address
Contractors Address
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SETBACKS REAR
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gEFT SETBACKSPLANHECKNO.nFV _IOPMO PL CHECK FEES $
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