HomeMy WebLinkAboutX2019-0674 - Permit Application�� Fmt;F' � - Worksheet for Building Combo Permit Application
r Comm'] j? Residential City of Newport Beach - Building Division 4/
NOTE: PLAN CHECK FEE DUE AT TIME OF SUBMITTALi w,
RBuilding (Grading F -Drainage F-Elec rMech rPlum Cu yd cut Cu Yd Filll
Project Address (Not mailing address)_ Floor Suite No
12332 Naples (Building 18: 2332-2347)
F_
Description of Work
Use
Re-coatprivatedecks /stairlandmgsand like-forlike'replacement
of damaged woodframing
# Stories(2 # Units (if Res) 12
members w ere occurs during daMPhIslwor .
New/Add SFr... -—Remodel SF Garage/New/Add
Valuation $ 82,000.00
Material/Labor
OWNER'S NAME Last Friedman
First Phillip
Owner's Address
Owner's E-mail Address
5500 Newport Center Drive
pfriedmanQirvinecompany.com
City Newport Beach StateA
Zip F926W Telephone[949-720-5468
APPLICANT'S NAME Last Matsushita
FirstiTak
Applicant's Address
Applicant's E-mail Address
1744 West Katella Ave 107
tmats11 ushit a@d I a]echristian.com
City Orange — State CA
Zip 92867 Telephone 714-997 1145
ARCHITECT/DESIGNER'S NAME Last
First F_' Lic. No.'�
Architect/Designer's Address
Architect/Designer's E-mail Address
(_
City v State F_
Zi Telephone[
p,I
ENGINEER'S NAME Last Christian
First pale �. Lic. No.SE2705
Engineer's Address
Engineer's E-mail Address
1744 West Katella Ave 107
dale@dalechristian.com
City Orange State CA
Zip 92867 Telephone 714-997-1145
CONTRACTOR'S NAME/COMPANY
Lk, No, Class
Contractors Address
Contractor's E-mail Address
City State F_
Zip F— Telephoner
'r ENERGY PIC FEE $ FIRE P/C FEE $
PERMIT NO.. I, of '
'GRADING P/C FEE $PLANNING P/C $
PLAN CHECK NO..
'.ELEC/PLUM/MECH PIC FEE $
PLAN CHECK FEE $
'':. DEVELOPMENT#
TOTAL FEES PAID $