HomeMy WebLinkAboutX2021-0141 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application a" °"e
City of Newport Beach - Building Division
)< Comm'I r Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
FX -Building F- Grading rDrainage [X—Elec FX- Mach FX- plum Cu rd curl Cu Yd Fill
Project Address (Not mailing address) r Flood r Fire r Liq j— Landslide FX N/A Floor Suite No
21151 Newport Coast Drive, Newport Beach, CA 92657 F
r�Description of Work r
use M/B Const Type V -B S�
Tenant improvement to remodel and exktinu retail spare within
converting from a previous GNC to an optometry retail store.
one story hoppingcenteL
#Stories #Units (if Res)
Valuation $ [$55,000
Material/Labor
New/Add SFF Remodel SF 1,368
Garage/New/Add �—
OWNER'S NAME Last Rosenblum
First Dr. David
Owner's Address -
Owner's E-mail Address
1201 N. Rose Drive
drdavid@eyesitemail.com
City Placentia State CA Zip 92870 Telephone(949) 510-9076
APPLICANTS NAME Last Voelker
First Todd
Applicant's Address
Applicants E-mail Address
T.S. Voelker Architecture, 14988 Sand Canyon Ave., #2
tsvarch@sbcglovbal.net
City Irvine State CA
Zip 92618 Telephone (949) 651-0300
ARCHITECT/DESIGNER'S NAME Last Voelker
First Todd Lic No. C21,595
Architect/Designses Address
Architect/Designer's E-mail Address
T.S. Voelker Architecture, 14988 sand Canyon Ave., #2
tsvarch@sbcglobal.net
City Irvine State CA
Zip 92618 Telephone (949) 651-0300
ENGINEER'S NAME Last Phua
_ First Raymond Lic. No.24509
Engineer's Address
Engineer's E-mail Address
102 Discovery
rayp@rpmpe.com
City Irvine State ca
Zip 92618 Teiephone (949) 450-1229
CONTRACTOR'S NAME/COMPANY
;7—To be determined
C s Ad � " ®w �
Lic. No. �jO�B' � Class ro
raacto
Contractor's E-mail Address
City�Gr� - / State
Zip Telephonej�
SETBACKS REAR SETBACKS FRONT
PERMIT NO. V Ol I ✓ O
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $