HomeMy WebLinkAboutXC2023-0417 - Permit Application (3)Print Form Worksheet for Combo Building & Solar Permit Application Sltl
�, Comm'I Residential City of Newport Beach - Building DivisionNOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
FJBuildin Grading Draina a Elec Mech :Plum CuYdCut 25 CuYdFill 199
Project Address (Not mailing address) C Flood F-,. Fire r7. Liq [_ Landslide F_N/A Floor Suite No
1600 Jamboree Road, Newport Beach, 92660
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Description of Work
Use Fuel ConstType II-B
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Removal of Hydrogen Fueling Equipment, demolition of portion ofCMU enclosure and
# Stories # Units (if Res)F. .
Dispenser.
dispenser, new fuel piping, related electrical work, and minor site improvements.
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Valuation $ r0,000
Material/Labor
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New/Add SF� Remodel SF[ � Garage/New/Add l�
OWNER'S NAME Last Samoylov ; First Konstantin
Owner's Address Owner's E-mail Address
650 California Street Suite 2250 j Konstantin.Samoylov@shell.com
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City San Francisco State �CA
I I Zip r94108 Telephone 619-850 2213
APPLICANTS NAME Last Toetz First Jimmy
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Applicant's Address Applicants E-mail Address
PP
299 N Euclid Avenue, Suite 550 I Jimmy.Toetz@Fiedlergroup.com
City Pasadena State CA Zip 91101 Telephone213-201-2528
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ARCHITECT/DESIGNER'S NAME Last ' First
� �—: Lic No. �—
Architect/Desi ner's Address ct/Designer's E-mail Address
City State Zip Telephone .
ENGINEER'S NAME Last Fiedler First Patrick I Lic. No. C-38123
Engineer's Address Engineer's E-mail Address
299 N Euclid Avenue, Suite 550 Patric k.Fiedler@Fiedlergroup.wm
City Pasadena State ItCA-- Zip 91101 Tele hone 213-381-7891
CONTRACTOR'S NAME/COMPANY f Fueling & Services Technologies Inc DBA Fast Lic. No..794519 Class C21 C is
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Contractor's Address Contractor's E-mail Address
7050 Village Drive, Suite D, Buena Park, CA 90621 gsegovia@fastechus.com
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City Buena Park State CA Zip 90621 Telephone 562-217-8059
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SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
XC2623-0gII