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HomeMy WebLinkAboutX2021-0100 - Permit ApplicationPrint Form F Comm'I r Residential FEulIdIngFGrading t Address (Not Sandcastle Dr. ;sheet for Building Combo Permit Application City of Newport Beach - Building Division y,&02,1_0100 &0L1_O100 NOTE: PLAN CHECK FEE DUE AT TIME OF SUBMITTAL ige r Elec r Mech r plum Cu — CuYdCut l Cu Yd Fill F 791 addrEsa1 New/Add SFF — OWNER'S NAME sinks at Floor Suite No Use # Storiesf 7 # Units (if Res)[ Remodel SF 75 Garage/New/Add 1 - Valuation $ Material/Labor 8798.00 Las. rKinn Owner's Address 979 Sandcastle Dr. CityCorona — - del Mar APPLICANT'S N Last IMills Applicant's Address 6611 Longfellow Drive City Buena Park State CA State CA ARCHITECT/DESIGNER'S NAME 1-� Lastl Architect/Designer's Address City �— State F� ENGINEER'S NAME Last Engineer's Address City F, CONTRACTOR'S NAME/COMPANY First I Jerry & Sharon Owner's E-mail Address Zip 92625 Telephone (949) 677-2714 First Mike Applicant's E-mail Address mmills2c0nsu ltmg@gmail. com Zip 90620 Telephone 714-336-5519 First 1 Lic. No. ArchitectlDesigner's E-mail Address Zip F� Telephoned____ First i Lic. No.F - Engineer's E-mail Address i State Zip Telephoned AMERICAN HOME REMODELING INC C. No. 807029 Class B, C 36 Contractor's Address 4375 PRADO RD SUITE 108 Contractor's E-mail Address daniel@goahr.com City Corona Zip 92880 State CA � Telephone (951) 520-0654 ENERGY P/C FEE $ �- FIRE P/C FEE $ GRADING P/C FEE $ PERMIT NO. ------- PLANNING P/C FEE $ —_ PLAN CHECK N ELEC/PLUM/MECH P/C FEE $ - DEVELOPMENT # PLAN CHECK FEE $ TOTAL FEES PAID $ California License #807029 December 11, 2020 To Whom It May Concern, Please allow this letter to serve as authorization for the following indiAduals to serve on our behalf, as a duly authorized agent for above mentioned company. And as such, the following individuals may obtain building/trade permits and obtain business licenses on our behalf. Please contact this office if you have any questions or comments. Aldo Mantellassi Austin Cabral Doug Randall Eugene Jones Jennifer Cole Judy Hallock Lital Cohen Michael Mills Randy Cole Rylinde Cole Victor Luna Alma Vinita Marilyn Warren Robert Ramsey Katherine Nebrida Sincerely, F r� 1. James Darling'` Owner/President CSLB# 807029; 4375 Prado Road, Suite io8 Corona, CA 92878 Tel# (951) 520-0654 Fax# (951) 520-0770 CALIFORNIA ALL-PURPOSE ACKNOWLEDGEMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. STATE OF California )SS COUNTY OF � 1 Ju::-) (7 On before me, \ Notary Public, personally appeared who proved to me on the basis of satiaactory,vidence to be the person(,,) whose nam e(Sf is/ re subscribed to the within instrum nt and acknowl dged to me that he/ e/the e ecuted the same in his/f6/tt�r authorized capacity(ies), and that by his!hZ signature(S`�on the instrument the person(x, or the entity upon behalf of which the person(S) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official �) ». Signature 61, `'�'� S. PERRY e, ) COMM #2266153 NOTARY PUBLIC -CALIFORNIA z RIVERSIDE COUNTY SS....°+« by My Comm65lon Expires Dec. 6, 2022 This area for official notarial seal. OPTIONAL SECTION - NOT PART OF NOTARY ACKNOWLEDGEMENT CAPACITY CLAIMED BY SIGNER Though statute does not require the Notary to fill in the data below, doing so may prove invaluable to persons relying on the documents. [] INDIVIDUAL C] CORPORATE OFFICERS) TITLE(S) PARTNER(S) ❑ LIMITED ❑ GENERAL ATTORNEY-IN-FACT TRUSTEE(S) C GUAP.DIAN/CONSERVATOR C] OTHER SIGNER IS REPRESENTING: Name of Person or Entity Name of Person or Entity OPTIONAL SECTION - NOT PART OF NOTARY ACKNOWLEDGEMENT Though the data requested here is not required by law, it could prevent fraudulent reattachment of this form. THIS CERTIFICATE MUST BE ATTACHED TO THE DOCUMENT DESCRIBED BELOW TITLE OR TYPE OF DOCUMENT: NUMBER OF PAGES SIGNER(S) OTHER THAN NAMED ABOVE DATE OF DOCUMENT ReprWucW by First American Tftle Company 11/2002