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Home My WebLink AboutXC2022-2034 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application rx— Comm'"s ' r— Residential City of Newport Beach - Building Division KC,26,ni 3Lt NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL jx Building r Grading rDrainage r Elec r Mech r' Plum Cu Yd Cutl Cu Yd Fill F Project Address (Not mailing address) F Flood r Fire r Liq F_ Landslide F_N/A Floor Suite No 510 Superior Ave Newport Beach, CA 92663 F F Description of Work Use Const Type 1 EARILER IN THE YEAR, WE RECEIVED CITY APPROVAL FOR A PROJECT THAT INVOLVED A NEW PETICT UNIT AND A NEW CT UNIT (PROJECT 2812-2021) THAT PROJECT WAS APPROVFD ON # StoriesF2 # Units (if Res)F FEBRUARY 9, 2022. DUE TO SUPPLY CHAIN ISSUES WITH THE PET/CT UNIT, THE PET/CT PORTION OF WORK WAS ELIMINATED IN REVISION 2 SO THAT HOAG COULD GET OCCUPANCY FOR THE New/Add SF F_Remodel SF 680 Garage/New/Add �— Valuation 150,000 Material/Labor bor OWNER'S NAME Last QUIRAM First BILL Owner's Address Owner's E-mail Address ONE HOAG DRIVE bill.quiram@hoag.org City NEWPORT BEACH State CA Zip 92663 TelephoneF— APPLICANT'S NAME Last LIEBKE First STEVE Applicant's Address Applicant's E-mail Address 1340 REYNOLDS AVE SUITE 115 sliebke@liebke.org City IRVINE State CA Zip 92614 Telephone 949-752-5052 ARCHITECT/DESIGNER'S NAME Last LIEBKE First STEVE Lic. No. C-28341 Architect/Designer's Address Architect/Designees E-mail Address 1340 REYNOLDS AVE SUITE 115 sliebke@liebke.org City IRVINE State CA Zip 92614 Telephone 949-752-5052 ENGINEER'S NAME Last STEPHEN First ZAJICEK Lic. No. E 10372 Engineer's Address Engineer's E-mail Address 150 PAULARINO AVE. SUITE All20 stevez@fbaengr.com City COSTA MESA State CA Zip 92626 Telephone (949) 852-9995 ONTRACTOR'S NAME/COMPANY 'Mzl Lic. No. F Class F Contractor's Address Contractor's E-mail Address (de 77 k96A -Av ,b , 6S , Z - c fy0 City GlL� '� State �— Zip Telephone-(i��_��C), SETBACKS REAR SETBACKS FRONT PERMIT NO. Y(4600-G� SETBACKS LEFT SETBACKS RIGHT ,,,,'�� PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ Worksheet for Electrical/Mechanical/ Plumbing Application EWER, Print Form City of Newport Beach �r 1. Project Address (Not mailing address) Building Permit NoBuilding Division. 510 Superior Ave Newport Beach,CA92663 Floor I' — Suite F— r— 2.Owner's Name Last Quiram First Bill Owner's Street Address One Hoag Drive City Newport Beach State F_ Zip 92663 Telephone F— Owner's E-mail Address bill.quiram@hoag.org r 3. Applicant's Name Last First Steve A lic am.s Street Et Address _ 1340 Reynolds Ave Suite 115 City Irvine State CA Zip 92614 Telephone 949-752-5052 Applicant's E-mail Address sliebke@liebke.org I— 4. Contractor's Name Last First State Lic # �— Contractor's Street Address Telephone I Contractor's E-mail Address Mechanical Furnace Quantity up to 100,000 btu:F over 100,000 btu-- wall/floor heaters Heat Pumps/Package Units up to 100,000 btu: up to 1,000,000 btu: up to 1, 750,000 btu: > 1, 750,000 btu: Boilers/Compressors up to 3 HP: 3 HP-15 HP: 15 HP-30 HPF_ 30 HP-50 HP:— >50 HP: Air Handling Units up to 10,000 CFM:— > 10,000 CFM: VAV Box F— Repair/Alter/Add HVAC Number of Zones: — Ventilation Bathroom Fan: Exhaust Fan: Attic Exhaust Residential Hood Commercial Hood Metal Fireplace: Gas Line Fire Dampers: City State F_ Zip Business Lic # Electrical Plumbing New Construction Quantity Bathroom Quantity Quantity 1 & 2 Family S.FF— Multi Family S.F:: Receptacle, Switch Lighting Outlets Total Outletsr Lighting Fixtures Total Fixtures Total Low Voltage Separate Circuit:: Motors/Transformers 0-1 HP or KVAF- 1-10 HP or KVAF- 10-50 HPorKVA:- 50-100 HP or KVA:— Over 100 HP or KVA[— Signs One branch circuit Add'I branch circuit Service 0-600V not over 200A: 0-600V & over 200A:: over 600V:— Temp PP/Piggy BackF— Sub PanelF— Other:— Water closet (toilet): Bidet �— Urinal :F_ Bath Tub:: Shower stall: Lavatory (basin)f — Hydro -massage tub: Kitchen Kitchen sink:: Garbage Disposal:: Bar sink Vegetable sink Dishwasher Laundry/washing trap: Ice maker: Floor sink:: Miscellaneous Floor drain: Water piping: Water softener: Water heater: Lavatory(basin):: Gas sys up to 4 outlets: Gas sys # of outlets over 4: Backflow device up to 2": Backflow device over 2": Regulators: Lawn Sprinkler System: Roof drains: Hose bibb:: Drinking fountain:: Grease trap: Grease interceptor: P-trap:: Sewer New sewer:: Sewer alter/repair:r— Sewer abandonment: