HomeMy WebLinkAboutX2019-0716 - Permit ApplicationPttni`Qrm _ Worksheet for Building Combo Permit Applicatiory
r
Comm'I Residential City of Newport Beach - Building Division
NOTE. PLAN CHECK FEE DUE AT TIME OF SUBMITTAL
RBuilding F_ Grading j—Drainage r—Elec
Project Address (Not main".
12 Laurent (Building 56: 112-119)
of Work
F Mech r— plum Cu Yd
Cu Yd Fill I
I
Floor
Suite No
Contractor's Address
Contractor's E-mail Address
... .... _ - -Use [_
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Re -coat private decks/stair landings and like-for-like'replacement of damaged wood framing 1=1,t ersw ere occurs uring eC Itt[ t wor , # Stories 2
#Units (if Res)r8
'�� 6ta'j
New/Add SFF— Remodel SF.F T Garage/New/Add — taiya Valuation $
Ma00.00
OWNER'S NAME Last Friedman-
First Phillip
Owner's Address Owner's E-mail Address
5500 Newport Center Drive
pfriedman@irvmecompany.com
City Newport Beach StateCA
Zip 92660 Telephone 949-720-5468
APPLICANT'S NAME
Fwm[susnna FirstlTak -.
Applicant's Address Applicant's E-mail Address
1744 West Katella Ave 107 tmatsushita@dalechristian com
City Orange State CA Zip 92867 Telephone 714-997-1145
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ARCHITECT/DESIGNER'S NAME i �M I ----T
--I LIC. No. l
Architect/Designer's Address Architect/Designer's E-mail Address
city F.—_...—'...,..^.__..__ state �r---_
_ ZIP f Telephian9['--
ENGINEER'S NAME .Last Christian First Dale
Lic No. SE2705
Engineer's Address Engineer's E-mail Address
1744 West Katella Ave 107 dale@dalechristian. com
CityOrange State CA Zip 92867 Telephone 714-997-1145
CONTRACTOR'S NAME/COMPANY Lic.No.
Contractor's Address
Contractor's E-mail Address
_.--�T
State F—
Zip F_ T.etel>honeF_-
city
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ENERGY P/C FEE $ _
FIRE P/C FEE $
PERMIT NO;
GRADING PIC FEE $
PLANNING P/C FEE $
PLAN CHECK NIS,
ELEC/PLUM/MECH PIC FEE $
-_.. PLAN. CHECK FEE $
DEVELOPMENT#
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TOTAL FEES PAID 5