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HomeMy WebLinkAboutX2019-0162 - Permit ApplicationPrint Form Worksheet for Building Combo Permit Application ��B Fx_ Cornm'I r Residential City of Newport Beach - Building Division a NOTE: PLAN CHECK FEE DUE AT TIME OF SUBMITTAL rx,Building F_ Grading rDrainage [x Elec Fx_Mech Plum CuvdCut F cuvdFill III Project Address (Not mailing address) Floor Suite No 7227 West Coast Highway I Description of Work Use Renovation ofexistingrcDffe oungeto ted electrical, lumbing,and # Stories # Units (if Res)F mechanical wor . t New/Add SF Remoli 185 � ,rage/New dd F Valuation $ F$1 0,000 Material/Labor OWNER'S NAME Last ce t c Ke 'ta m First BALBOA BAY CLUB VENTURES, LLC Owner's Address Owner's E-mail Address 2532 Dupont Drive City Irvine State CA Zip 92612 Telephone 949-861-4700 APPLICANT'S NAME Last Martin, Jr., (Sr. Project Manager) First William Applicant's Address Applicant's E-mail Address 1350 Coronado Avenue wmartin@ko-al.com City Long Beach State CA Zip 90804 Telephone 562-597-8760 ARCHITECT/DESIGNER'S NAME Last Kollin First Michael', Lic. No. C21173 Kollin Altomare Architects Architect/Designer's Address Architect/Designer's E-mail Address 1350 Coronado Avenue City Long Beach State CA Zip 90804 Telephone 562-597-8760 ENGINEER'S NAME Last %.V Firstit Lic. No. a QQ AM �s' SCJ(,) Engineer's Address Engineer's. Addres City ! -- State F Zip F- TelephoneF- CONTRACTOR'S NAME/COMPANY' I f(,ul Coy) s`ruct%'on lnC_ Uc.Nc. gieCA$_J Class Contractoorar's Address - - Contractor's E-mail Address �J w.l" tU�1r lYl AV�'_-_ s�'�ve.u�ilso ✓���Ce, Stiv_c'l ,c,n ce'^h Cdy'1-GS_-_�Ie�)ot5 ,, State Iii Zip -_g� 1 Telephone-ip2--`I�12.-BNw ---� ENERGY P/G FEE $ FIREP/C FEE $ PERMIT NO. x ao 1-1 �^- Q/ W G DIN1 P/C1FEE $ PANNING P/C FEE $ PLAN CHECK NO. d' 3� t'IF(l /MECH P/C FEES PLAN CHECK FEE $ D E,,LL/O MENT # DWI 1 q R7 0 -5� TOTAL FEES PAID $