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HomeMy WebLinkAboutX2021-1526 - Permit Application (2)Print Form Worksheet for Building Combo Permit Application ' ®r.6Z Comm'I r Residential City of Newport Beach - Building Divisio NOTE: PLAN CHECK FEE DUE AT TIME OF SUBMITTAL UZBuilding r- Grading r-Drainage F Elec F Mech f- Plum cuvdCut s-- cevdFill Project Address (Not mailing address) Floor Suite No 2750 West Coast Highway j r- Description of Work Lighting Upgrade: Install (4) pole mounted fixtures. Install Use Fa( ,Exterior 6) canopy py mounted fixtures. 'Replace (7) canopy mounted fixtures Replace (2) wall mounted fixtures Remove (1) flood It Stories # Units (if ResF 0 mounted fixture -patch & paint. Remove (2) canopy mounted fixtures -patch & paint. Remove (1) Di � Valuation$ 20� Material/Labor000.00 New/AddSF10Remodel SF Garage/New/AddF0 OWNER'S NAME Last lWells Fargo First Owner's Address Owner's E-mail Address 1 Home Campus, 5th Floor City Dyes Moines State IA Zip 50328 Telephonei(915) 85_— 2-6156 APPLICANT'S NAME Last First Timothy Mit&X llrb - Applicant's Address l� �Applicant''s E-mail Address yh. SI'E) W kJ(—vv l/ a@bureauvedtas.com at hp2 •5b1 •'I113 I State F1TL( Zip 17815 ei2�t�(pTelephonel(5"r'$60-3ts- - ARCHITECT/DESIGNER'S NAME Last First F_ Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address City F State F_Zip r` Telephone[ — ENGINEER'S NAME Last Sander First Neil Lic No. C66470 Engineer's Address Engineer's E-mail Address 102 Farnsworth Avenue Independence@indepeng.com City IBordertown State NJ Zip 08505 Telephone (609) 496-9369 — CONTRACTOR'S NAME/COMPANY JCennox Lic No 921843 Class CIO Contractor's Address Contractor's E-mail Address 13010 Santa Fe Ct - - — City Missoula State Mt Zip 59808 Telephone l(915) 852-6156 ENERGY P/C FEE $ FIRE P/C FEE $ - PERMIT NO. W211 • 1 52yo GRADING P/C FEE $ PLANNING P/C FEE $ PLAN CHECK NO. 1�2q2,Uss ELEC/PLUM/MECH P/C FEES PLAN CHECK FEE $ It 50.11 DEVELOPMENT # TOTAL FEES PAID $