HomeMy WebLinkAboutX2021-2002 - Permit Applicationi- `/ City of Newport Beach - Building Division �2p2I- 20D 2 �
�' Comm'I Residential - NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL uc<„owr�
r,Building r Grading
rainage,Elec (x',Mech �! �'
_ ix, Plum CU Yd C,t Cu Yd Fill 0
Project Address (Not mailing address) [ Flood i-, Fire r_, Liq J_ ndslide (xN/A Floor Suite No
2161 San Joaquin Hills Road, Suite 103 Fist 10-
Description of Work
Use Const Type V-
onv rt th xisting685SF Yoga Room into a Medical Suite which includes 1 Exam Diagnostic
Room, Vision & Hearing Room,
# Stories # Units (if Res)F_
Staff Work Room and 1 Private Office
Valu "
Labor' 85,000
al/ $
n
New/Add SF 0
Remodel SF 685 Garage/New/Add 0
OWNER'S NAME
Last Schilling First Michele
Owner's Address
Owner's E-mail Address
31240 Seven Mile Beach
City Grand Cayman
State Cay. Isla Zip KY1-1205 Telephone(345) 926-1123
APPLICANT'S NAME
Last Burghard First AI
Applicant's Address
Applicant's E-mail Address
41951 Remington Avenue, Suite 250 aeb@bdg-architects.com
City Temecula
State CA Zip 92590 Telephone (951) 296-2828
ARCHITECT/DESIGNER'S NAME Last Burghard First AI Lic. No. C-13795
Architect/Designer's Address
Architect/Designer's E-mail Address
41951 Remington Avenue,
Suite 250 aeb@bdg-architects.com
City Temecula
State CA Zip 92590 Telephone (951) 296-2828
ENGINEER'S NAME
Last First F777777 Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City
State F__ Zip f Telephone
CONTRACTOR'S NAME/COMPANY Lic. No. t?j2 ClassFff
Contractor's Address
Contractor's E -malt -Address
TBD 'api ar��11 C JI ?or e-� �1QnDcLvn5�2c+ai1.�1
City I (Js �n°�L'
State I LCL' Zip Telephone�—
SETBACKS REAR
SETBACKS FRONT PERMIT NO. J .r
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK N0.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $ �' !�