HomeMy WebLinkAboutX2018-3519 - Permit Application (3)X7,01?-3siq
Print I orris Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division g
0 Comm'I [' Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F]Building i] GradingDrainage [ Elec [ Mech ❑Plum cu vd cuc 3011 co Yd Fill 1690
Project Address (Not mailing address) �' Flood Fire ❑ Liq Landslide rN/A Floor Suite No
393 Hospital Road I _J L _J
Description of Work
Grading and underground utility work for new assited living building
Use R2.1/Al ConstType
# Storiess7 # Units (if Res) 85 l
Valuation $
New/Add SF 76,591 J Remodel SF Os Garage/New/Add 10
Material/Labor
OWNER'S NAME Last ryg First Matt
ins_ _ --
Owner's Address Owner's E-mail Address
tna Senior Living - 300 East Market Street, #100 Matt.Winsryg@atriaseniorliving.com .
cityLouisville State ��
I Zip F0202 I Telephone 14-267-5416 i
APPLICANT'S NAME Last
Applicant's Address
19000 MacArthur Blvd, #500
City Irvine _ State CA
i.
Applicant's E-mail Address
oshuas@pancakearchitects.com
Zip 92612 Telephone 949-720-3850
J
ARCHITECT/DESIGNER'S: NAME
Last Pancake _ _ First Douglas Lic. No. C27254— J
Architect/Designer's Address
Architect/Designer's E-mail Address
19000 MacArthur Blvd, #500 _ — oshuas@pancakearchitects.com
City Line _ _ State Zip 92612 Telephone 949_720-3850
CA —
ENGINEER'S NAME Last Khomsi First li Lic. No. 4768
Engineer's Address
18400 Von Karmen, #600
City Irvine State CA
Engineer's E-mail Address
ravis.antonissen@kpff.com
Zip 92612 —I Telephone 949-252-1022
CONTRACTOR'S NAME/COMPANY RD Olson J Lic. No. 953845 Class
Contractor's Address
955 MAIN STREET 3RD FLOOR
City Irvine State CA
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
Contractor's E-mail Address
drudd@rdolson.com
Zip 92612 Telephone 949-474-2001
PERMIT NO.
PLAN CHECK NO.
USE "LONE DEVELOPMENT NO PLAN CHECK FEES $