HomeMy WebLinkAboutX2021-0465 - Permit Application (2)/ - Ptin¢Form Worksheet for Combo Building & Solar Permit Application q (P3EWPo�
Ix COmm'I j Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL a
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Project Address (Not mailing address) Flood r Fire r Liq j- Landslide jxN/A FSuite No
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700 NEWPORT CENTER DRIVE,Y FLOOR
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Description of Work
Use IB Const Type1-A
DEMOI (TION OF FXISriNG OFFI PA INTERIOR FINISHES AND NnN-BFAgINC pAR1IBONS--
TOBRING INTERIOR BACKTO SHELL CONDITION FOR FUTURE TENANT IMPROVEMENT # Stories # Unit (if R s)�
New/Add SF�— Remodel SF 1,543 Valuation $
Garage/New/Add �— 10
Material/Labor '
OWNER'S NAME
Last BALFOUR First SARAH
Owner's Address
700 NEWPORT CENTER DRIVE Ow'ner's E-mail Address
SARAH. BALFOUR@PACIFICLIFE.COM
City CA
Zip 92660 Telephone 949-219-3011
NEWPORT BEACH State
APPLICANT'S NAME Last H. HENDYASSOCIATES
First ADEY ANTHONY
Applicant's Address -
14770 CAMPUS DRIVE, SUITE 100 Applicant's E-mail Address
AANTHONY@HHENDY.COM
City NEWPORT BEACH State CA
Zip 92660 Telephone 949-851-3080
ARCHITECT/DESIGNER'S NAME
Last DWYER First SUSAN Lic. No. C-33724
Architect/Designer's -
14170 CAMPUS DRIVE, SUITE 100 Architect0esigner's E-mail Address
SDWYER@HHENDY.COM
city NEWPORT BEACH State CA
Zip 92660 Telephone 949-851-3080
ENGINEER'S NAME
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Lic. No.�—
Engineer's Address Last Firs
Engineer's E-mail Address
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City State — Zip [� TelephoneF —
CONTRACTOR'S NAME/COMPANY
PA541 •ZVkj .Z-1 L'Uj�7 � O Lic. No. � Classl
Contractor's Address
Contractor's E-mail Address
Gv/LrShll JLF G% 4)447, 0207)
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city Stat
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Zip D'-tw;77 Telephone -7/�7/��� - C
SETBACKS REAR — SETBACKS FRONT
SETBACKS LEFT SEPERMIT Nr t 00%4UU ✓ ,
SETBACKS RIGHT PLAN CHECK NO. D(�T C2�Zt]
USE ZONE DEVELOPM22
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PLAN CHECK FEES $
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