HomeMy WebLinkAboutX2021-2839 - Permit ApplicationComm'I fr Residential
Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division ), '25Z0 — 9.533e1
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
r...Building r Grading (Drainage 7Elec r- Mech r Plum cu Yd Cut
Project Address (Not mailing address) r Flood r Fire r Liq r Landslide
Cu Yd Fill
rN/A Floor
Suite No
ONE HOAG DRIVE NEWPOR��TTj''//BEACH, CAp926�63
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Description of Work �jt A 1QM, WWI(kviA con WOO.
Use
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RACKS TO BUILDING 21 AT HOAG HOSPITAL. BUILDING 21 IS A NON-OSHPD BUILDING. NO NEW
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CONSTRUCTION IS INVOLVED EMERGENCY POWFR FOR THE 4 DATA RACKS AND CALL
STATIONS WILL COME FROM EMERGENCY POWER PANELS INSIDE THE HOSPITAL. A SEPARATE
PERMIT WILL ALSO BE OBTAINED FROM OSHPD FOR THE EMERGENCY POWER WORK.
# Sto es
1 # Units (if Res)
Valuation $
New/Add SF)
Remodel SF1
11,2_� Garage/New/Add
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Material/Labor
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OWNER'S NAME Last
Owner's Address
BILL First
Owner's E-mail
IQUIRAM
Address
IONE HOAG DRIVE
City
INEWPORT BEACH State
CA Zip
192663 Telephonel
APPLICANT'S NAME Last ILIEBKE
Applicant's Address
First
Applicant's E-mail
ISTEVE
Address
11340 REYNOLDS AVE SUITE 115
SLIEBKE@LIEBKE.ORG
City
IIRVINE State
CA Zip
196214 Telephone1949-752-5052
ARCHITECT/DESIGNER'S
Architect/Designer's
NAME Last
Address
ILIEBKE
First
Architect/Designer's
ISTEVE
E-mail
Lic. No. 1C-28341
Address
11340
REYNOLDS AVE SUITE 115
SLIEBKE@LIEBKE.ORG
City
IIRVINE State
CA Zip
196214 Telephone1949-752-5052
ENGINEER'S
Engineer's
NAME Last
Address
!STEPHEN
FirstIZAJICEK
Engineer's
E-mail Address
Lic. No.IE
10372
1150
PAULARINO AVE. SUITE A120
stevez@fbaengr.com
City
(COSTA MESA State
CA Zip
I92626 Telephone(949)
852-9995
CONTRACTOR'S NAME/COMPANY
Contractor's Address
Lic.
Contractor's E-mail Address
No.
ei
I Class
58 (57...__s
I
City
I State
Zip
Telephonel
SETBACKS REAR SETBACKS FRONT PERMIT NO.
V \- t
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SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
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USE ZONE DEVELOPMENT NO PLAN CHECK FEES $