HomeMy WebLinkAboutX2011-1322 - Permit ApplicationPrint Form Worksheet for Building Combo Permit Application
City of Newport Beach - Building Department
Please print 3 copies
FkBuilding l.,_ Grading r'`Drainage r-Elec F Mach I Plum
1. Project Address (Not mailing
9.630 NCD
X2h11-1322
G-3o N eW (,)0rt CN't
,m
Floor Suite No
1
Tenant Narr if Applicable)
# Units (if Residential
2. Descri lion of Work
_.._... P _„
Wost Utility EncIosuro1,t9'-6"W
x 20'-a"I-i;
__._....__ _._
Use
__. ..-..,.,..
Ejsf Utility Enclosure sR6 19"W x 20'-7"H
_.._..
_
'
Extg Building SFf
Demo Building SF F
Valuation
I
Add/Reconstruct Bldg SF
/
Exl Gar sf
A
.._,—.,—...
Demo Garage sF F _.._,
Add/Reconstruct Garage at F.._._._,.�
_.
# Stories
F.._.._,.....,
.... ...
TOTAL SLOG SF
Cu Yd cut
New � Add
(— Alter ("'-Demo
TOTAL GARAGE SF
F
Cu Yd FIII
Check Appropriate Box for Applicant
k 3. Owner's Name Last,Carey
First Tim
Owner's Address
Owner's E-mail Address
1101nnovation
tcarey@irvinecompany.com
City Irvine State
CA
Zip 92617 Telephone 949-720-2000
(X-4.Architect/Designer'sName Last Kelly
First James Lic, No,
Architect/Designer's Address
5961 California Avenue Suite 100
Architect/Designer's E-mail Address
-
gbroming@Ipalnc.com Gloria Broming
City Ilrvine State
[CA
Zip 192617 Telephone 949-261 1001
IX 5. Engineer's Name Last [McLellan
First (Mark Lic. No.; 51031
Engineer's Address
Engineer's E-mail Address
19 Technology
I'pat,osborne@stantec.com
City Irvine State
[CA _
Zip �92618 Telephone949-923 6000
19 B. Contractor's Name Last ITBD
First Lic. No. Class
Contractor's Address
Contractor's E-mail Address
City State—
Zip I Telephone
OFFICE USE ONLY ENERGY P/C FEE $
PERMIT NO. - '" —Z
GRADING P/C FEE $ FIRE
P/C FEE$
PLAN CHECK NO. 33CS2r�
Rev4116109 ELEC/MECH/PLUM P/C FEE $
PLAN CHECK FEE $