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HomeMy WebLinkAboutX2019-1124 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application (K Comm'I [- Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL [-Building r Grading [—Drainage IX Elec r Mech FX- Plum Cu Yd Cut Cu Yd Fill F Project Addre Not mailing address) [- Flood r Fire [- Liq F Landslide [-N/A Floor Suite No 1 &2 100/zoo/z2 0360 Birch t. #100 00 #220 2,'15 Description of Work G �+ � _'' k Use � Const Type II -6 Interior Office, Medical Office, and Ambulatory Surgery Center tenant improvement projects in # Storiesl2 # Units (if Res)F an existing medical office building. Work to de done in 3 separate suites. Generator outside. New/Add SFr Remodel S Garage/New/Add �— Valuation $ 0 Material/Labor[1,200,0( OWNER'S NAME Last Eden Fertility Center First Owner's Address Owner's E-mail Address 20360 Birch Street, #200 niall@architectsoc.com City Newport Beach State CA Zip 92660 9497210730 APPLICANT'S NAME Last I \T_elephone First �i q tn. Applicant's Address Applicant's E-mail Address X160 tr�.�. Si' b11q�..v. vho�r�s —u s A. co vI^ City State L Zi�oTelephone TT —237 _701r ARCHITECT/DESIGNER'S NAME Last Saunders First Nll Lic. No. C-26955 Architect/Designer's Address Architect/Designer's E-mail Address 700 West Coast Hwy. #200 'ared@architectsoc.com City Newport Beach State CA Zip 92663 Telephone9497210730 ENGINEER'S NAME Last Joseph First ntolin Lic. No.37240 Engineer's Address Engineer's E-mail Address 914 E. Katella Ave. mzubair@peica.com City naheim State CA Zip 92805 Telephone 7143851835 CONTRACTOR'S NAME/COMPANY Offis IhC Lic. No.q� Class F3 Contractor's Address Contractor's E-mail Address ` Q�� ��- 22 "kQPi city """ f - State CA- Zip Fq7& Telephone 79ic, log SETBACKS REAR n z SETBACKS FRONT PERMIT NO. -6 � d SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ (Oq5>