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City of Newport Beach - Building DivisionMDTZ O 9 t Comm I j� Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL cClcpaNP
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Project Address (Not mailing address) F_ Flood Fire F_ Liq (m Landslide F_N/A Floor Suite No
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Description of Work
Use Const Type
# Stories #Units (if Res)
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SNay PV 2 .-2 KW
Valuation $
Material/Labor
New/Add SF Remodel SF Garage/New/Add F—
OWNER'S NAME Last F
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Owner's Address Owner's E-mail Address
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APPLICANT'S NAME (fin First Al I q
Last _ I - t � �� . �_�ilii�-{� i�i 6 l
Applicant's Addreds Applicant's E-mail Address
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City FmL 1_ 6 _v 1 O State Zip Telephone Cj H q u (0q 5 ( (
ARCHITECT/DESIGNER'S NAME Last First Lic. No,
Architect/Designer's Address Arch itect/Designer's E-mail Address
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City State �0 Zip F Telephone
ENGINEER'S NAME Last First Lic. No.
Engineer's Address Engineer's E-mail Address
City State Zip �® Telephone
CONTRACTOR'S NAME/COMPANY _- J G Morn Lic. No. b ZGj561 Class
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Contractor's Address Contractor's E-mail Address
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City F State F Zip F Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $