HomeMy WebLinkAboutX2021-1389 - Permit Application (3)Print Form I Worksheet for Combo Building & Solar Permit Application°a>
Comm'I F_ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL -
Fx-Building r Grading
F-Drainage rElec (-Mech F Plum Cu Yd Cut Cu Yd Fill F
Project Address (Not mailing address) r Flood F_ Fire F_ Liq F_ Landslide FN/A Floor Suite No
4000 MACARTHUR BLVD.
NEWPORT BEACH, 92660
1st FDescription
of Work
C1 �t
/ ,t 1�_
u t-M
Use I Const Type 1-A
PARTIAL FLOOR TENANT IMPROVEMENT
TO INCLUDE: DEMOLITION. NON-STRUCTURAL
# Stories 10 # Units (if Res)
PARTITIONS, SUSPENDED
CEILING ASSEMBLIES, LIGHTING, DOORS, FINISHES AND
ASSOCIATED ELECTRICAL,
MECHANICAL, AND PLUMBING IMPROVEMENTS.
New/Add SF�
Remodel SF 3,888 Garage/New/Add
Valuation F,720.00
Material/Labor
bor
OWNER'S NAME
Last HIGUCHI First AMY
Owner's Address
Owner's E-mail Address
4000 MACARTHUR BLVD.
SUITE 280
City FNEWPORT BEACH
State CA Zip 92660 Telephone 949-313-2212
APPLICANT'S NAME
Last WILSON First MIKE
Applicant's Address
Applicant's E-mail Address
17877 VON KARMAN AVE, SUITE 200 M.WILSON@INTERIORARCHITECTS.COM
City I IRVINE
State CA Zip 92614 Telephone949-798-7321
ARCHITECT/DESIGNER'S NAME Last KELLY First PiA 32528
Lic. No.
Architect/Designers Address
Architect/Designer's E-mail Address
17877 VON KARMAN AVE,
SUITE 200 L.KELLY@INTERIORARCHITECTS.COM
City I IRVINE
State CA Zip F92614 Telephone 949-798-7303
ENGINEER'S NAME
Last First Lic. No.�
Engineers Address
Engineer's E-mail Address
City
State �— Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY Lic. No. F Class
Contractor's Address
Contractor's E-mail Address
City
State Zip Telephone
SETBACKS REAR
SETBACKS FRONT PERMIT NO. Vw- 1 ;) sA
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO Vw t PLAN CHECK FEES $
Print Form 1 Worksheet for Combo Building & Solar Permit Application
Comm'I I-" Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Sit
Building F_Grading r—Drainage F_Elec I—Mech F7Plum Cu vd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood F_ Fire F_ Liq F_ Landslide F_N/A Floor Suite No
4000 MACARTHUR BLVD, NEWPORT BEACH, 92660 _ 1st 110
Description of Work
Use FB — Const Type 1 A
PARTIAL FLOOR TENANT IMPROVEMENT TO INCLUDE: DEMOLITION. NON-STRUCTURAL
# Stories 10 # Units (if Res)F—
PARTITIONS, SUSPENDED CEILING ASSEMBLIES, LIGHTING, DOORS, FINISHES AND
ASSOCIATED ELECTRICAL, MECHANICAL, AND PLUMBING IMPROVEMENTS
Valuation $
New/Add SFF_ Remodel SF F3,888 - Garage/New/Add
F2720 00
Material/Labor
OWNER'S NAME Last HIGUCHI First AMY
Owner's Address Owner's E-mail Address
4000 MACARTHUR BLVD, SUITE 280
City NEWPORT BEACH State CA - - Zip 92fi60_ Telephone 949 313-2212
APPLICANT'S NAME Last WILSON First MIKE
Applicant's Address Applicant's E-mail Address
17877 VON KARMAN AVE, SUITE 200 M.WILSON@INTERIORARCHITECTS.COM
City I IRVINE State CA Zip r92614 Telephone _949798-7321 -
ARCHITECT/DESIGNER'S NAME Last KELLY First Lic. No.
LISA 32528
Architect/Designer's Address Architect/Designer's E-mail Address
17877 VON KARMAN AVE, SUITE 200 L.KELLY@INTERIORARCHITECTS.COM
City I IRVINE -- State CA - Zip 92614 Telephone 949.798-7303 --
ENGINEER'S NAME Last First Lic. NoT
Engineer's Address Engineer's E-mail Address
City State F Zip F Telephoned
CONTRACTOR'S NAME/COMPANY Grmt�tllV�l���� ink Lic No. i class
�v
Contractor's Address Contractor's E-mail Address
h�6G W hl�y 9"Ort Ot"r 0-- - rn fiztt-4d. wm
City State j/%I Zip q�1L I Telephone O (q _ l?
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
Np �/�/�,U�,, 1
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