HomeMy WebLinkAboutX2019-0496 - Permit ApplicationPrint Form ] Worksheet for Combo Building & Solar Permit Application . o4�EW�,
%� lq - 01-iqO City of Newport Beach - Building Division
T Comm'I r Resi ential
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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r, Building F_Grading F -Drainage r-Elec F_Mech F7 Plum Cu Yd cut F Cu Yd Fill
Project Address (Not mailing address) F' Flood [ Fire F- Liq F-, Landslide ['N/A Floor Suite No
5000 BIRCH STREEET 1 1400
Description of Work !/ u / %L
Use Const Type 11DV�
WHITE BOX: DEMOLITION OF INTERIOR PARTITIONS, POWER.CE�y FINISHES AND LIGHTING
# Sto es 10 ,� #Units (if Res)
EXISTING FIRE LIFE SAFETY TO REMAIN IN TACT
Valuation
Material/Labor
Remodel SF 36 Garage/New/Add
New/Add SF F_6,0
OWNER'S NAME Last MULCAHY-RODRIGUEZ First DIONNE
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Owner's Address Owner's E-mail Address
5000 BIRCH STREET, SUITE 120 Dionne_Mulcahy-Rodriguez@jhancock.com
City NEWPORT BEACH State CA Zip 92660 Telephone9493859361
APPLICANT'S NAME Last QUEVEDO First MARK
Applicant's Address Applicant's E-mail Address
17877 VON KARMAN AVE SUITE 200 M.QUEVEDO@INTEIORARCHITECTS.COM
City IRVINE State CA Zip 92614 Telephone 9493008131
ARCHITECT/DESIGNER'S NAME Last KELLY First LISA Lic. No. 32528 I
Architect/Designer's Address Architect/Designer's E-mail Address
17877 VON KARMAN AVE SUITE 200 L.KELLY@INTERIORARCHITECTS.COM
City IRVINE State CA Zip 92612 Telephone 9497987310
ENGINEER'S NAME Last N/A First Lic. No.7
Engineer's Address Engineer's E-mail Address
City State Zip Telephone
CONTRACTOR'S NAME/COMPANY TBD Lic. No. (q yss, Class
Contractor's Address Contractor's E-mail Address
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City �vS/� es�a- _ StateZip 9 Teleph6ne 7/C/__21//-��/3G�
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S TWCKS REAR SETBACKS FRONT PERMIT NO.
W,14BACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
U ONE DEVELOPMENT NO PLAN CHECK FEES $