HomeMy WebLinkAboutX2019-0717 - Permit Applicationipr,ntForm r Worksheet for Building Combo Permit App lic on
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Comm'l Q Residential City of Newport Beach - Building Division
KlnTM. PLAN CHECK FEE DUE AT TIME OF SUBMITTAL
REluticing r Grading F'-Drainage I—Elec 7Meth f plum
Project Address, (Not mailing address)
cuvdcu covdwl
100 Laurent (Building 57: 100.111) Floor Suite No
Description of Work -
Re-coat private decks/stair landings s Woneforlike'replacementofdamaged wood framing Use
If
mem eYSw ei2 occurs Urmg a ori wt,
# Storiesl2 # Units (if Res) 70
New/Add SF � .Remodel SF�� Valuation $
Garage/New/Add Material/LaborF�00
,000-
OWNER'S NAME -
Last Friedman First Phillip
Owner's Address - -
's
5500 Newport Center Drive OwnerE-mail Address
ptnedman(M rvinecompany.com
City Newport Beach State CA
Zip 92660 Telephone 949-720-5468
APPLICANT'S NAME--------�
Last IMatsushita First ITak
1744 West Katella Ave 107 Applicant's E-mail Address
limatsU$hM@dalechristian.com
City Orange--- StateCA
Zip 92867 Telephone 714-997-1145
ARCHITECT/DESIGNER'S NAME'
Last` Firstf�_.--
Architect/DesignersAddress Lic. No. f'
_., Architect/Designer's E-mail Address
city
#. State F Zip f, Telephone��
ENGINEER'S NAME Last Christian
t
Engineer's Address -. First Dale Lic No. SE2705
1744 West Katella Ave 107 Engineers E-mail Address
dale@dalechristian. com
City Orange State CA
Zip 92867 Telephone 714-997-1145
CONTRACTOR'S NAME/COMPANY
-. .Lic. No, F._.__.-._.... Class F_Contractor's Address -
_.. Contractor's E-mail Address
City...._...._.., State I•'�_____-_
j Zip Telephoned
ENERGY P/C FEE $ FIRE P/C FEE 5 PERMIT NO,
GRADING P/C FEE $ q" • D_'j i'�_
PLANNING P/C FEE $
PLAN CHECK NO,
ELEC/PLUM/MECH P/C FEE $
DEVELOPMENT # '-^"— — PLAN CHECK FEE $
TOTAL FEES PAID $