HomeMy WebLinkAboutF2020-0152 - Permit Application."a,Int� Worksheet for Comfs it & I s er it Application
jX Comm'I Residential City of po each wilding Division{ m
NOTE: PLAN CHECK FEES DUE AT TIME ()F RI IRMITTAI `�)
FBuilding F_Grading
F—Drainage r: Elec Mech ry Plum Cu rd Cut Cu Yd Filll
Project Address (Not mailing address) r7 Flood r Fire Fl Liq r Landslide F_N/A Floor Suite No
20331 Irvine Ave, Newport Beach, CA. 92660 !
Description of Work
Use Const Type T7
Install Medical Gas and Vacuum
� �
System to Surgery Center ,Y
a� # StoriesF1 # Units (if Res)j
New/Add SFr
Remodel SF F
I e/New /Add Materia ; Valuatiol/Lan 5 bor 32,000.00
Garag
OWNER'S NAME
Lastnton First Mark
Owner's Address
20331 Irvine Ave E6
Owner's E-mail Address
-- —
markanton@me.com
City Newport Beach
State CA Zip 92660 Telephone (714)330-0096
APPLICANT'S NAME
Last Hodge First Chris
Applicant's Address
_
Applicant's E-mail Address
6527 lg Springs Rd.
biomed u inc
9 Y @gmail.com
City [Lake Isabella
_ Zip 3240 Telephone(661)331-4935 i
ARCHMECT/DESIGNER'S NAME
—`CA
lState
l �9 Lic. No. F_.__..
Lash n First' `
Architect/Designer's Address
Architect/Designer's E-mail Address
270 Elderberry St
y�
ason@jccdes[gn.com
City La Verne
750
State CA Zip 91Telephone (909)969-4747
ENGINEER'S NAME
Last First F - LijNovEngineer's
Address
Engineer's E-mail Address
City (��State
Zip Telephonej
CONTRACTOR'S NAME/COMPANY RX Plping Lic. No.41435 Cl 36
Contractor's Address
Contractor's E-mail Address
8309 Laurel Canyon Blvd., Ste. 153 rxpiping@Venzon.net
ity Sun Valley
CA (818)749-1788
State Zip 91352 Telephone
ETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. �.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $