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HomeMy WebLinkAboutX2017-3530 - MiscX2011-3530 216 Gacnel Ave CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 St�.rs3�.:F_:;-� �P��:'u__:s3Ye0'._�,3k3]i.kw'n;;:s'd4fi�sS:rm*i:nY>�'k_++�c'att5:':"vi-�•'-�-nr`.;x.'f-�F-. 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 County of On 0611'A^l a�,-;L�ri before me, Date Here Insert Nome and Title of the dtficer personally appeared F Pi,_, —^c. firn Ae— Nome(s) of Signer(s) � who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(les), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. CORINNE L. BLACK Notary Public - California San Luis Obispo County Commission If 2179779 My Comm. Expires Feb 11, 2021 + Place Notary Seal and/or Stamp Above 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 seal. Signature _—Signature of Notary Public OPTIONAL Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: = Capacity(ies) Claimed by Signers) Signer's Name: lVit/ Qas F %Qr ❑ Corporate Officer — Title(s): ❑ Partner— D Limited ❑ General ❑ Individual ❑ Attorney in Fact ia'Trustee ❑ Guardian of Conservator ❑ Other: Signer is Representing: 02017 National Notary Association i NumberofPages: �- Signer's Name: 14" P v D Corporate Officer — Title(s): ❑ Partner— ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact er7rustee ❑ Guardian of Conservator ❑ Other: Signer is Representing: M1304-09 (09/17) CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 ��rg: �t'S!R:+'_3f..- e�s�:itx� ��ooht:�u<:.x,>a3tL+t�Rssi€rs:�n:tt:.€,=::a3•� s:w`tx?r 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 D County of J&,VL Z Oltyo n/t On Od`c Re -.2(a, X17 before me, [ Oflnrfc, L. L3 Lack, kz-�;r*,11 Lb 1, Date A Here Insert Name and Title of the ficer personally appeared I V i c-11" eeks F �I � °-"`t' U''� "'t ^-n^ 10t QY- Nome(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. CORINNE L. BLACK Notary Public - California z San Luis Obispo County Commission # 2179779 My Comm. Expires Feb 11, 2021 > Place Notary Seal and/or Stamp Above 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 seal. Signature (__Z�t . ignature of Notary Public Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document:-rko.-;3 L*T+ ,C -f 'fes f" - &AA ff fy'�"'�' Document Date: J NumberofPages: ';Z— Signer(s) Other Than Named Above: Capacity(ies) Claimed by Sfgner(s) Signer's Name: A t<,I.� %/ v ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General D4in'divldual ❑ Attorney in Fact ❑ Trustee o Guardian of Conservator ❑ Other: Signer is Representing: ©2017 National Notary Association Signer's Name: ,lima a �w D Corporate Officer — Title(s): ❑ Partner— ❑ Limited ❑ General CN'Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian of Conservator ❑ Other: Signer is Representing: M1304-09 (09/17) X901 3530 916 Gorne� Ave CITY OF NEWPORT BEACH COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 100 Civic Center I P.O. Box 17681 Newport Beach, CA 92658-8915 www.newoortbeachca.00v1(949)644-3200 SUBSTANTIAL IMPROVEMENT COST DETERMINATION PROPERTY ADDRESS: , CO L/� Q F -.IT 1AVE DATE: APPLICANTS NAME:S-�- V I� ll' ++ /�/� CONTACT NUMBER: LICENS CONSTRUCTION COST DETERMINATION Primary Description of Work Under t e roposed Permit: Valuation lX _Pt/ 1� 0.1)Wt4 T1 )�� S (A1)$ Open Permit # Description of Work Valuation (A2)$ 2. (A3)$ 3. (A4)$ 4. (A5)$ ff tnI+A2+n3+n4+A5=A6l Combined Valuation: (A6)$ l MARKET VALUE DETERMINATION ��,r� v 1. Value of Structure: $ Gl.<i 00 2. Percent Depreciation: �z i�2 % 3. Depreciation Amount: $1COO - �� 4. Value: $ 000 (A7)Total (AM Combined Valuations >_ or:5 50% (A7)Total Value r m et)anee' e ) (A7) a Forms:Subs, ntiallmpmv mentCastOefetminstion 3-13 X201,7-31530 ,216 6arne4 Live j ca v�- ce. tk-q � � o re r m J ca ose-- W � Vl 0 V\+- C� C) 1 � vi C) r �c Wim- �� Vl(D. �- f-e� v V\ -d,