HomeMy WebLinkAboutX2011-1955 - Permit ApplicationrX comm.! r Residential
Worksheet for Building Combo Permit Application
City of Newport Beach - Building Division
NOTE: PLAN CHECK FEE DUE AT TIME OF SUBMITTAL
i-,Building I-. Grading (Drainage gU Elec IR Mech r- Plum cuvd cut
Project Address (Not mailing address)
j Cu Yd Fill
fff
Floor
Suite No
I400owest-Goast-Highway- cE. 1�C ,pei�lJi
$t j5i@LL)
Basement
[
Description of Work
l/C�.�r Ir`
Remove abandoned stand-alone Central Plant equipment with chillers, cooling tower, filter and !
Use
water treatment system. Dumas. accessories. electrical and controls. Tie-in new to perature
pressure and flow meter to Central plant BMS. New labelling and insulation on Mech piping and
..
it Storiesl3
U Units (if Res)
_ ..._
Valuations
1. !r '..
New/Add SF1
Remodel SFI861
Garage/New/Add
I •
Material/Labor
1 U 0 t-'
OWNERS NAME Last
Owner's Address
(Hoag Memorial Hospital Presbyte First'
Owner's E-mail
Address
3r—A
SPr.
2 °CC-
'One
Hoag Drive
Igregg.zoll@hoag.org
City
(Newport Beach State
CA
I92658-6100 Telephone1949-764-4468
Zip
APPUCANT'S NAME Last
Applicant's Address
'Neal First I Mich ael
Applicant's E-mail Address
15670 Oberlin Drive lmichael.neal@exp.com
City (San
Diego State
CA Zip 192121
Telephonel858-597-0555
ARCHITECT/DESIGNER'S
Architect/Designer's
NAME Last
Address
IN/A
First
Architect/Designer's
I
E-mail Address
Lic. No. I
I
1
City
I State
l Zip
I Telephonel
ENGINEER'S
Engineer's
NAME Last
Address
ITrzepacz
First
Engineer's
'Michael
E-mail Address
Lic. No.IM33288
1451
Montgomery, 3rd Floor
Imichael.trzepacz@exp.com
City
'San Francisco State
CA Zip
I94104 TelephoneI415-362-5025
CONTRACTOR'SNAME/COMPANY
Contractor's Address
(Not yet selected '?eS1a4t_
A-frec f .r
cohtt jc o'a, Lic.
.
Contractor's E-mail Address
No.
IR33?S4 Class
1 20042 WI tk..itl 9r: 4 a rre 3or,
I a lex I e 9ves44§V covS4-rvcrdo.•
. c.o.s- -
city
I..'(o1•r 1.. .. , State
("' Zip
I ?'.(obo.... Telephonel
°wy- tsp. oc
ENERGY P/C FEE $ FIRE P/C FEE PERMIT NO. X2n I I —ID SS
IMJ$u PLAN CHECK NO.
GRADING P/C FEE$ PLANNINGPEE $
ItjLED - Lot
``
15 - Z- PLAN CHECK FEE $
ELEC/PLUM/MECH P/C FEE $ 2- l • t S
- O3
ttq
201� # TOTAL FEES PAID $
DEVELOPMENTG 0
' '
-
CITY OF NEWPORT BEACH