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PROJECT FILE INFORMATION
530 Superior (Bldg 4)
Suite 100
Plancheck #0369-2004
B2004-0475
Submitted 02/09/2004
Planning Department approval:
02/23/2004 (LLevin)
Zone: M 1-A
JBZ Architecture + Planning
(Research and Development per J. Campbell)
lst floor
approx. 17,544 U.S.F. (per building summary on plans)
WORKSHEET FOR BUILDING / FIRE PERMIT APPLICATION
Po A£ BUILDING DEPARTMENT CITY OF NEWPORT BEACH
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PLEASE PRINT OR TYPE ��� °"��
1. PROJECT ADDRESS (NOT MAILING ADDRESS)
15;�o Su R-,oF— Su IrE IDO
LEGAL DESCRIPTION
LOT BLOCK TRACT
2. DESCRIPTION OF WORK _ TQ,hQ V) I� 1 VVipVDV2V11LJ2
NEW ADD ❑ ALTER M DEMO ❑
Check Apppopplale Box lop Applicant
m II
USE Dr-P4GE
# OF STORIES
VALUATION $ !J56,990.I
SQFT 1-754
(NEW/ADDED/ XTG)
3. OWNER'S NAME LAST FIRST
Tk C.<-ar(F- Gom.-pw'I H
OWNER'S ADDRESS
OWNER'S E-MAIL ADDRESS
4001 M P c A P—rI-j Iy r- FI—vD i�- I ov
CITY STATE ZIP
PHONE NO.
N2--r ?jei-e+ Grp 01: 66
(cWt)q�'_6399
4. ARCHITECT/DESIGNER'S NAME LAST FIRST
LIC. NO.
H • 4 F o u?Lt R-t�oc47re ,�, Co nl r Az-r
C 19 2 a¢
ARCHITECT/DESIGNER'S ADDRESS
ARCHITECT/DESIGNER'S
E-MAIL ADDRESS
Z415• 5u1Tt7 110
TLb5 aD 4+1-!
N1pgxrm
CITY STATE ZIP
PHONE NO.
112vIN5 0-6- 0I�2-1P1;2-
(949 861-5o8a
5. ENGINEER'S NAME LAST FIRST
STATE LIC. NO.
--rVY1 A-v
ENGINEER'S ADDRESS
ENGINEER'S E-MAIL ADDRESS
1 oo 50u-rI+ A-Nj r +Ff,1 m f5L,v17 15b
CITY STATE ZIP
PHONE NO.
A-rtA-fl-vm Gar 072805
49o-055:5
6. CONTRACTOR'S NAME
�•S
BUSINESS LIC.
STATE LIC.
'I
No. Class
CONTRACTOR'S ADDRESS 01'ryOP]w �iCONTRACTOR'S
E-MAIL ADDRESS
CITY STATE FEB 0 5 P004
PHONE NO.
OFFICE USE ONLY
PERMIT NO. 13UOq, r)Lf-7—c*5
TYPE OF CONSTRUCTION JIL PLAN CHECK NO. q- 200
PLAN CHECK FEE $ I �i V(o 4 1,
OCCUPANCY - GROUP PLAN CHECK ENG.
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