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X2022-0909 - Permit Application
Worksheet for Combo Building & Solar Permit Application r, Comm'I F_ Residential City of Newport Beach - Building Division `g�,�, (�/�� NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL' V' ;Building F_Grading rDrainage r,Elec fj(Mech Fx_Plum CuvdCut r CuvdFill Project Address (Not mailing address) F_ Flood r Fire F_ Liq andslide r_N/A Floor Suite No 5010 Campus Dr. I 120 Description of Work Use Const Type VB SprIN # Stories #Units (if Res) Dermatology and Primary Care 2.731 SF medical clinic tenant improvement within and existing warm shell building Valuation $ New/Add SFF Remodel SF7— Garage/New/Add $330,000.00 Material/Labor OWNER'S NAME Last Alaghband First Fred Owner's Address Owner's E-mail Address Newport Campus LLC 5020 Campus Dr. Suite 250 falaghband@acsirvine.com City Newport Beach State CA Zip 92660 Telephone 949.263.1920 APPLICANT'S NAME Last Schafer First Michael Applicant's Address Applicant's E-mail Address 23192 Alcalde Dr. Suite G mschafer@msa-corp.net City Laguna Hills State CA Zip 92653 Telephone r949.584.5426 ARCHITECT/DESIGNER'S NAME Last Schafer First Michael Lic. No. C-13366 Architect/Designer's Address Architect/Designer's E-mail Address 23192 Alcalde Dr. Suite G mschafer@msa-corp.net Ciry Laguna Hills State CA Zip 92653 Telephone 949.584.5426 ENGINEER'S NAME Last First I Lic. No. Engineer's Address Engineer's E-mail Address City-- State F Zip I Telephone CONTRACTOR'S NAME/COMPANY Column4Construction Lic. No. 992770 Class l` Contractor's Address Contractor's E-mail Address 5020 Campus Dr. Suite 250 alan@column4construction.com City Newport Beach State CA Zip 960 Telephone 26949.337.0884 SETBACKS REAR SETBACKS FRONT PERMIT NO. /V-7 z-z — () 70 q SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. OSLt© -202Z USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ 36 ci5 i 33