HomeMy WebLinkAboutX2019-1933 - Permit ApplicationPrim FormL Worksheet for Building Combo Permit Application
Co i;m I [- Residential y201 q-jg33 City of Newport Beach - Building Division 0101-20jq
NOTE: PLAN CHECK FEE DUE AT TIME OF SUBMITTAL
,,ling Trading [—Drainage Fx_ Elec [- Mech [- Plum Cu vd cut 0 Cu Yd Fill Io
Project Address (Not mailing address) Floor Suite No
lintersection of Center Dr. and San Simeon Drive �—
Description of Work
Use
i KKTAi i ATinN OF lni-Gana min CROWAIAl K FLASHERS
# StoriesF_ # Units (if Res)F—
Valuation $
New/Add SFF Remodel SF 1,500 Garage/New/Add r
15,000.00
Material/Labor
OWNER'S NAME Last IRIVNE MANAGEMENT COMPf idyl First BRYAN PEELING
Owner's Address Owner's E-mail Address
550 NEWPORT CENTER DRIVE
City NEWPORT BEACH State CA Zip 92617 Telephone 949-720-2000
APPLICANT'S NAME Last STANTEC (LYNN DIAZ) First
Applicant's Address Applicant's E-mail Address
38 TECHNOLOGY LYNN.DIAZ@STANTEC.COM
City State F_ Zip F TelephoneF_
ARCH ITECT/DESI GNER'S NAME Last First— Lic. No. F_
Architect/Designer's Address Architect/Designer's E-mail Address
City IRVINE State CA Zip 92618 Telephone 949-923-6266
ENGINEER'S NAME Last BEUCHAT First BRAD Lic. No.[ --
Engineer's Address Engineer's E-mail Address
38 TECHNOLOGY BRAD. BEUCHAT@STANTEC.COM
City IRVINE State CA Zip 92618 Telephone 949-923-6257
CONTRACTOR'S NAME/COMPANY ��� � gV`�QfS JA C_ Lic No.t'ogClass
Contractor's Address Contractor's E-mail Address
zoo F Vi`(6(11®redVV\WKb cL--rs.Gorn
City �twn-e - State CA Zip �Ct � Telephone q,411 - -751,1-7650
ENERGY P/C FEE $ FIRE P/C FEE $ PERMIT NO.
GRADING P/C FEE $ PLANNING P/C FEE $ PLAN CHECK NO. nit) i -z-oil
ELEC/PLUM/MECH P/C FEE $ PLAN CHECK FEE $ !e <Z--0
DEVELOPMENT # TOTAL FEES PAID $
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