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PriWorksheet for Building Combo Permit Application o~` ""r
City of Newport Beach - Building Division�oiq �zge
F. Comm'I ❑ Residential NOTE: PLAN CHECK FEE DUE AT TIME OF SUBMITTAL °""
Gradin Draina a Elec Mech
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Project Address (Not mailing address)
Floor Suite No
2531 Eastbluff
Description of Work
Use
# Stories7 # Units (if Res)F-I
-
Valuation$ 250,00000
Material/'Labor
New/Add 5FF— Remodel SF t't l i� Garage/New/Add
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OWNER'S NAME Last IRVINE COMPANY First ELIZABETH McKENNA
- ---
Owner's Address
owners E-mail Address
110 INNOVATION
City IRVINE State CA
Zi 92617_ _- Telephone 949-720-6000
APPLICANT'S NAME Last (STANTEC), DIAZ
First LYNN
Applicant's Address
Applicant's E-mail Address
38 TECHNOLOGY
LYNN.DIAZ@STANTEC.COM
State CA
Zip 92618 Telephone 949-923-6266 '
City IRVINE
__
ARCHITECT/DESIGNER'S NAME Last
First—Lic. No. �—
Architect/Designer's Address
Architect/Designer's E-mail Address
City State F_'
ZIP �—�, Telephone—'
ENGINEER'S NAME Last OSTROM First BRANDON Lic. No. Z7 2''.
Engineer's Address
Engineer's E-mail Address
38 TECHNOLOGY
BRANDON.OSTROM@STANTEC.COM
City IRVINE State CA
_
Zip 92618 Telephone 949-923-6160
NAME/COMPANY
T• f U.�--.
Lic No. �jj'. Class
CONTRACTOR'S
-
Contractor's Address
Contractors Address
-mail
F"
City State �''..
q' p� �1r
Zip L � ��_ Telephone *0 iP k
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FIRE P/C FEE $
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PERMIT NO. x- IR • V Y� ��r
ENERGY P/C FEE $
PLAN.CHECK NO. 0ZoS •2o I -1
GRADING P/C FEE $ PLANNING P/C FEE $
ELEC/PLUM/MECH P/C FEE $
PLAN CHECK FEE $
TOTAL FEES PAID $
DEVELOPMENT#