HomeMy WebLinkAboutX2019-0712 - Permit ApplicationWorksheet for Building Combo Permit Application
r Comm I [Z Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEE DUE AT TIME OF SUBMITTAL v ».
RBZ
rading rDrainage rElec I-Mech r Plum Cu YdCut �
Cu Yd Fill
PrOss (Not mailing: address)
'Floor Suite No
300lo (Building 52:300-307} I I
Desrk
_.. Use �.
Re -coat private decks/ stairlandincsand'like-for-lika'ranu o o . Fa �. __ ___
New/Add SFF —, Remodel SFF � Garage/New/Add I
OWNER'SNAME -- - -`----
Last Friedman Fust Phillip
Owner's Address Owner's E-mail Address
5500 Newport Center Drive pfriedman@irvinecompany.
City Newport Beach State CA
- . Zip 92660 Telephor
APPLICANT'S NAME L tIAA
S
# Units (if Res)r8
as atsushita
FirstTak
--;nts Address
.,.
Applicant's E-mail Address
1-744
1744 West Katella Ave 107
tmatsushita@dalechristlan.com
City FOrange
State CA
Zip 92867 Telephone 714-997-1145
ARCHITECT/DESIGNER'SNAME
Last F First F �
Lic. No �^
Architec7Designer's Address
Architect/Designer's E-mail Address
city
State —
Zip f� TelephoneF�.
ENGINEER'S NAME Last Christian
Fust Dale Lic. No. SE2705
Engineer's Address
Engineer's E-mail Address
1744 West Katella Ave 107
dale@dalechristian.com
�
City Orange
State CA
Zip 92867 Telephone714-997-1145
CONTRACTOR'S NAME/COMPANY
Lic. No. �� Class
Contractor's Address
Contractor's E-mail Address
City
State
ZIP f�.. Telephoned-.
ENERGY P/C FEE $
FIRE P/C FEE $
PERMIT NO,
00 IZ
GRADING P/C FEE $
PLANNING P/C FEE $
- -
PLAN CHECK NO„
ELEC/PLUM/MECH P/C FEE $
_... PLAN CHECK FEE $ --
:DEVELOPMENT#
TOTAL FEES PAID $