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HomeMy WebLinkAboutX2022-1499 - Permit ApplicationF, Comm', r Buildin9 Worksheet Residential TOr �'+'• Uivision City of Newport Beach - Building OF SUBMITTAL NOTE: PLAN CHECK FEES DUE AT 71ME Cu Yd Fin Elec Grading [:Drainage!. roject Address 1j•"" 320 Campus Dr. description of work 2 295 SF non surgical orthc within an existing warm she New/Add SF _. _-- pWNER'S NAME Mailing Plum Cu Yd Cut Mech (x; -- - Fire [. Liq [_ Landslide r Flood [, Remodel SFF7� Last Garage/New/Add Owners Address us Dr. Suite 250 - us LLC 5020 Camp -- NewportCamp --- --- " State CA - - wport Beach city Ne First IF red FWA Floor Suite No -. 1177 210 Use , ConstType VBS_", # Stories # Units (if Res1� Valuation 5 $270,000 Material/Labor Owner's E-mail Address falaghband@ acsirvine com ----- oAq 263.1920 M. First Last Schafer APPLICANT'S NAME -- -_ Applicant's E-mail Address msa corp net --__ Applicant' Suite mschafer@ --- Suite G -- - 949.584.5426 - -- _ - Telephone - 23192 Alcalde Dr. Zip g2653 - State CA -- Lic.No. C-13366 una Hills - City Lag _- - - First Michael _ - ARCHITECTIDESIGNER'S NAME Last Schafer -- _- �2r3192 chitectlDesigner's Address Alcalde Dr. Suite -_ State CA city Laguna Hills _ - - - ArchitectlDesignees E-mail Address mschafer@msa-corpnet- - _ --__ ---- Telephone 949.584_5-4T - Zip 92653 - Lic. NO- ------� ENGINEER'S NAMELast------- Engineer's Address --- - "- _ - State City - CONRACTOR'S NAME/COMPANY T Engineer's E-mail Address Zip Telephoner_ —_ column 4Construction - __ ___---- Contractor's Address 5020 Campus Dr. Suite 25 -- -__- State C City Newp ort Beach -- SETBACKS FRONT _ ETBACKS REAR SETBACKS RIGHT _ ETBACKS LEFT �� DEVELOPMENT NO _ Class Lic No. 992770 _ Contractor's E-mail Address alan @colu mn4construchon. co _ ----- - Telephone 949_337 0884 F?F660 - Zip xto2t - PERMIT NO. 14q,Z — PLAN CHECK NO. , pLAN CHECK FEES $ SE ZONE