HomeMy WebLinkAboutX2011-0843 - Permit Applicationlir 31
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Worksheet for Building Combo Permit Application
City of Newport Beach - Building Department
Building 1— Grading I-
Tenant Name(if Name(if Applicable)
CCie,--1--Z-CLIt- bp -
Drainage pglec -ntltech I- Plum
1. Project Address (Not mailing address)
I c._> OL-441— S-0-6)
ape, Stinsc peAst%e # Units (if Residential) use
2. Description of Work -r'X- SPEC. Su t Aeefku-e,e-
Extg Building SFj
Extg Gar sf
fl New
F
Add
16ere12.-
cooye---
Demo Building SF
Demo Garage sf
IAAlter E Demo
Add/Reconstruct Bldg SF
Add/Reconstruct Garage sf I
TOTAL BLDG SF I
TOTAL GARAGE SF I
(co
Floor
---2
Suite No
Valuation $
41Z
# Stories
2r--A see
B
Check Appropriate Box for Applicant
r
3. Owner's Name
Owner's Address
Last
City
r- 4. Architec
State
Zi
First
Owner's E-mail Address
Telephone
s Name Last I/A.L.iCa4_,
Architect/Designer's Address
City
GO-' *220
S..State
Zip
First
Architect/Designer's E-mail Address
Lic. No.i
CSJOESI IN-DL c-n---
-rdephonen4V1 5 1-(011L
5. Engineer's Name Last
First
Engineer's Address Engineer's E-mail Address
City
State 1--
Zip
Lic. No.
Telephone;
IT 6. Contractor's Name Last
First
Lic. No.
Contractor's Address Contractor's E-mail Address
City State
9vrao Oki eir 11 204
OFFICE USE ONLY ENERGY Pc F,#E $52 0 PERMIT NO
GRADING P/C FEE $ FIRE P/C FEE $ PLAN CHECK NO. 0544 -kat
Class
Zip
Telephone
Rev 4/16/09 ELEC/MECH/PLUM P/C FEE $ 14.1-to of)ct PLAN CHECK FEE $ • SS