HomeMy WebLinkAboutXC2022-2063 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application E Po'm
F_ Coni 1— Residential City of Newport Beach - Building Division 1, 3
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL kC✓ZU1.1.- IMT,�
F_Building r- Grading
F-Drainage (—Elec I—Mech r Plum CuYdCut s CuYdFill
Project Address (Not mailing address) r- Flood 1— Fire r Liq r Landslide rN/A Floor Suite No
510 SUPERIOR AVE
F— too
Description of Work
Uses ConstType s
COMM INSTALL X-RAY EQUIPMENT
AND T-BAR SUSPENDED CEILING AND LIGHTING 443 SF
# StoriesF # Units (if Res)[_
Valuation $
New/Add SFr_
Remodel SFs Garage/New/Add F
F0000
Material/Labor
OWNER'S NAME
Last HEALTHCARE NEWPORT First
Owner's Address
Owner's E-mail Address
1 HOAG DR
City I NEWPORT BEACH
State CA Zip F2663 Telephoner
APPLICANT'S NAME
Last CHAVEZ First CAEZAR
Applicant's Address
Applicant's E-mail Address
770 CAMPUS DR
DWYER@HHENDY.COM
City NEWPORT BEACH
State CA Zip F2660 Telephone 49-851 3080
ARCHITECT/DESIGNER'S NAME Last DWYER First SUSAN Lic. No.
Arch itect/Designer's Address
Architect/Designer's E-mail Address
770 CAMPUS DR
City NEWPORT BEACH,
State CA Zip r Telephone
ENGINEER'S NAME
Last � First F_ Lic Nos —
Engineer's Address
Engineer's E-mail Address
City
State F_ Zip F_ TelephoneF_
CONTRACTOR'S NAME/COMPANY t�11 L Lic No. CIC�G ycj<{ Class
���t �.�7
l k/ r�` Of
Contractor's Address
Contractor's E-mail Address
city r
State F_ Zip F Telephones
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $