HomeMy WebLinkAboutX2011-1486 - Permit Applicationrint For
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Worksheet for Building Combo Permit Application
City of Newport Beach - Building Department
;Building r' Grading fDralnage r1Elec r.Mech
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S,
1. Project Address (Not mailing address)
Floor
'One Hoag Drive, Building 44
PCA-lt t'akk
Tenant Name(if Applicable) t-Ev W C, t.)
et4)
2. Description of Work
(Tenant Improvement u p cijw
Exist House SF 91.134 DemoHouse SF
Exist Gar SF
2nd
Suite No
210
# Unit (If Residential) I-.
i ste. Qc �e---1-e-44aAkt
Add/Reconstruct House SF
7,883
Demo Garage SF j Add/Reconstruct Garage SF 1
Add r! Alter r Demo
TOTAL HOUSE SF
TOTAL GARAGE SF
Use 'Office
Valuation $ 180,
dtZ 1000
r #Stores �3
Cu Yd Cut-
Cu Yd Fill li••..
Check Appropriate Box for ADDlicant
r; 3. Owner's Name Last
(Hoag Hospital REFCO First'
Owner's Address Owner's E mail Address
1500
Superior Avenue, Suite 300
City 'Newport
Beach
State
CA Zip
92663 I
Telephonel949-764-4486
r 4.
Architect/Designer's
Architect/Designer shame Last
Address
'
Wood
-----_
First
Architect/Designer's
'
Rick
E-mail Address
Lit.
No.
C15130 '
11800
Quail Street, Suite 120
Irick.wood@wbsarch.com
Ciry'Irvine
State
CA
Zip
192660 , Telephone1949-552-2061
r 5.
Engineer's
Engineer's Name Last)
Address
j First
Engineer's
l
E-mail Address
Lic
NO.I
City'
State
� Zip
Telephone'
r 6. Contractor's Name Last
I . First
I l Lic. No.
Class
Contractor's Address Contractor's E-mail Address
I_
City
(....,_..___...... State
� Zip �f Telephon
IAI®
OFFICE USE ONLY ENERGY P/C FEE $ 53 . �,1PERI�I��JQ.
°011XZC�
O
GRADING PIC FEE $ PLAN ci r . r ,0
Inc
1" LO I t
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