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HomeMy WebLinkAboutX2020-1831 - Permit Applicationi=rint.Form , Worksheet for Combo Building & Solar Permit Application )_( Comm'I r, Residential City of Newport Beach - Building Division Y7oyv^ tgw` NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL !!tt rBuilding r Grading Address r_ -Drainage r, Elec r; Mech r Plum cu Yd cut Cu Yd Fill 1-7 r Flood n Fire r; Liq r Landslide rN/A Westcliff Drive #104, Newport Beach, CA 92660 Floor Suite No Description of Work UseConst Type (1) Illuminated Wall Sign 2.50 x 15.00'= 37.50 SF - -- - # Stories' # Units (if Res)F - Valuation $ 2000.00 New/AddSFF Remodel SFF7— Garage/New/Add F7777 Material/labor OWNER'S NAME Last Owner's Address First Owner's E-mail Address 2043 Westcliff Drive #210 _ . State Zip 92660 Telephone 949-645-1236 City Newport Beach _ CA APPLICANT'S NAME Last First Applicant's Address Applicant's E-mail Address 5301 Barstow Street pacneon@san.rr.com City San Diego State CA Zip F777Telephone 858-735 4080 ARCHITECT/DESIGNER'S NAME Last First Lic. No.F-- Architect/Designers Address City State Architect/Designer's E-mail Address Zip �— Telephoner ENGINEER'S NAME Last FirstF—, Lic. No.F— Engineer's Address city State F— Engineer's E-mail Address Zip [_ Telephoned CONTRACTOR'S NAME/COMPANY Pacific Neon Lic. No.748088 Class C45 Contractor's Address 5301 Barstow Street City San Diego State CA Contractor's E-mail Address pacneon@san.rccom 92117 85-735 4080 Zip Telephone8 SETBACKS REAR SETBACKS FRONT SETBACKS LEFT SETBACKS RIGHT USE ZONE DEVEL M I ' 01"� PERMIT NO. PLAN CHECK PLAN CHECK FEES $ �EWPpRr o em Community Development Department n Planning Permit Application 9a. C4<IFORN�P xt�zo- eV bt 1. Check Permits Requested: ❑ Approval -in -Concept - AIC # ❑ Coastal Development Permit ❑ Waiver for De Minimis Development ❑ Coastal Residential Development ❑ Condominium Conversion ❑ Comprehensive Sign Program ❑ Development Agreement ❑ Development Plan ❑ Lot Line Adjustment 2. Project Addresses)/Asses: 3. ❑ Lot Merger ❑ Limited Term Permit - ❑ Seasonal ❑ < 90 day ❑>90 days ❑ Modification Permit ❑ Off -Site Parking Agreement ❑ Planned Community Development Plan ❑ Planned Development Permit ❑ Site Development Review - ❑ Major ❑ Minor ❑ Parcel Map s Parcel NOW CITY OF NEWPORT BEACH 100 Civic Center Drive Newport Beach, California 92660 949 644-3200 newportbeachca.gov/communitydevelopment ❑ Staff Approval ❑ Tract Map ❑ Traffic Study ❑ Use Permit -❑Minor []Conditional ❑ Amendment to existing Use Permit ❑ Variance ❑ Amendment -❑Code ❑PC ❑GP ❑LCP I Other: Sign Project Description and Justification (Attach additional sheets if necessary): (1) Illuminated Wall Sign 2.50'x. 15.00'= 37.50 SF S 4. Applicant/Company Nametan Ideker /Pacific Neon 5301 Barstow Street Mailing Address Suite/Unit City San Diego I State I CA Zip 92117 858-735-4080 pacneon@san.rr.com Phone Fax � Email 5. Contact/Company Name I Stan Ideker / Pacific Neon 5301 Barstow Street Mailing Address Suite/Unit San Diego CA 92117 City State Zip � J 858-735-4080 pacneon@san.rr.cem Phone FaxF-1 Email Waterpointe Commercial 6. Owner Name 2043 Westcliff Drive #210 Mailing Address Suite/Unit Newport Beach CA 92660 City state zip Phone 949-645-1236 I Fax F1 Email S 7. Property Owner's Affidavit*: (I) (We)ee Attached Landlord Signed Rendering depose and say that (I am) (we are) the owner(s) of the property (ies) involved in this application. (1) (We) further certify, under penalty of perjury, that the foregoing statements and answers herein contained and the information herewith submitted are in all respects true and correct to the best of (my) (our) knowledge and belief. Signature(s): Title: I Date: DD/MO/YEAR Signature(s): Title: I Date: I *May be signed by the lessee or by an authorized agent if written authorization from the owner of record is filed concurrently with the application. Please note, the owner(s)' signature for Parcel/Tract Map and Lot Line Adjustment Application must be notarized. F]Users\CDD\ShamdWdmint lanning_Divislon Appliwtions Appilmdon_GuidellnesViannin8 Permit Application -COP added.dom Rev: 0124/17