HomeMy WebLinkAboutX2011-0469 - Permit ApplicationPlease print 3 copies
Worksheet for Building Combo Permit Application
City of Newport Beach - Building Department
1 :;Building j-X Grading r"'Drainage ''OElec F'Mech
6T0 Negoff(reynter
U _ yr
C9[Ie4M1e�P
-III.-Project Address (Not mailing address) Floor Suite No
f _
Tenant Name(if Applicable) N/A # Units (if Residential)
Description2. of Work
Use
ariz _ i loot
Ext Building SF � Demo Building SF_ Add/Reconstruct Bldg SFValuation $
Extg Gar sf Demo Garage sf Add/Reconstruct Garage at # Stories
New �"- Add �" Alter �®Demo
TOTAL BLDG SF (... Cu Yd Cut [69,513
TOTAL GARAGE SF�I Cu Yd Fill [320
(`hur4 enn�nnnin#n Rnv fnr ennlin�n0
r_ _ _._
`' 3.Owner's Name Last Carey
____._rv_.
.----------
First Tim
Owner's Address _ _ _
1550 Newport Center Drive
Owner's E-mail Address
[tcarey@Irwnecompany.com
City INPB State
CA
Zip 92660 Telephonel949-720-2000
15Z 4. ArchitecVDesigner's Name Last Kelly
_m—__ ".__..-----..___
First James Lic. No. 102336
Architect/Designers Address
LPA Inc. 5161 California Avenue, Suite 100
Architect/Designer's E-mail Address
gbroming@lpainc.com Ex 10.31.11
City [Irvine State
Fa _
C
___ Zip �92617 Telephone ;-949-683-7848 vY
5Z 5. Engineer's Name Last Mcl_ellean
_ IFirstMark) _.. Lic. No. RCE 51031
Engineer's Address
Stantec 19 Technology Dr.,Suite 200
i_ _
Engineer's E-mail Address
pat Osborne@stantec com
City [Irvine State
_
ECA
"_a-r ____._®.
Zip 9�618 Telephone1949-923-6275
'
f _6. Contractor's Name Last
_ i,.____—___
First(� ( Lic. No. Class
Contractor's Address
it pi
0\1 Contrac C'B^,"EPliGia Address
O
City i _. State__
.__._...._. Zip.... Telephoned _..
OFFICE USE ONLY ENERGY P/C FEE $
PERMIT NO. ml i — "'�,�y�
GRADING P/C FEE $ FIRE P/C
2 �
CHECK NO. f( /� `
FEE $f�-
�"�
Rev4/16/09 ELEC/MECH/PLUM P/C FEE $ ��
aPLAN
���PLAN CHECK FEE $
2-0
, Form
lase print 3 copies
Work>i, et for Building Combo Perm!,._ ,pplication "7p Newpor-Center
City of Newport Beach - Building Department o ,(MFOP by
R-Building X Grading ["Drainage I` Elec F Mech R Plum
1. Project ddress (Not mailing address)
� ._ _ �,_ �_ _ j�Flo'o'r� Suite No
1630, 650, �701';and 690 Newport Center Drive l I �—
Tenant Name(if Applicable) �N/A rL( .l rig ��{ f , r, #(Units if Residential)
2. Description of Work l�-ems
_ Use F_� _..�.._._
Site wet/dry utilities relocation, ite demo, precise grading, sii1.
` Valuation $�f)d;70
Exig Building SF� Demo Building SF Add/Reconstruct Bldg SF
Extg Gar at Demo Garage sf� Add/Reconstruct Garage sf F # Stories
iX New I— Add X Alter FX Demo
Check ADDropriate Box for Applicant
TOTAL BLDG SF I Cu Yd Cut 82,460 -
TOTAL GARAGE SF F Cu Yd Fill 16,840,
X 3. Owner's Name Last Ron
First Keith
Owner's Address
550 Newport Center Drive
- Owner's E-mail Address
keith@irvinecompany.com
City INPB State (CA
Zip 92660 Telephone 949-720-2000
X 4. Architect/Designer's Name Last Kelly
�K
First James _ Lic. No, iC12336
Architect/Designer's Address
....
Architect/Designer's E-mail Address
ILPA, Inc. 5161 California Avenue Suite 100
gbroming@lpainc com Exp 10.31.11
City Irvine State CA
Zip 92617 Telephone�949-701-4008
FX`5. Engineer's Name Last bermte 2 c2 c�° First i �—
o n hLL% .� t � Lic.No.��j(
Engineer's Address
19 Technology Drive, Suite 200
L i
Engineer's E-mail Address
pat.osborne@stantec.com
City 3Irvine State CA m
Zip C92618 Telephonel949=923-6275
F 6. Contractor's Name Last
First! t 1/! Lic. No. F ClassFi;_
Contractor's Address 'V oz ,>'J.'r-
Contractor's E-mail Address
V"fO�C'1$1�.>G�`
City �.,._� , _ State
Zip•, _., Telephonel�q��jc� r
OFFICE USE ONLY ENERGY P/C FEE $
PERMIT NO.
GRADING P/C FEE $ FIRE P/C FEE $
PLAN CHECK NO.
Rev4176109 ELEC/MECH/PLUM P/C FEE $
PLAN CHECK FEE $