HomeMy WebLinkAboutF2021-0466 - Permit Application— „ ' City of Newport Beach - Building Division VV (� I g
Please print 3 copies S �" �aoRH
Associated Building Permit # F Fire Sprinkler ire Alarm j Fire Misc
1. Project Address (Not mailing ad ress) Floor Suite No
Tenant Name GICL) Z-p�iJ(f} r�F [►1 to i �Cloi "" - #Units !®
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2. Description of Work
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Valuation
Extg Sq Ft New/Added Sq Ft Total Sq Ft
r New r', Add r Alter F_ Demo tories
Check Appropriate Box for Applicant/Notification
F_ 3. Owner's Name Last
First
F
Owner's Address
Owner's E-mail Address
City _._
I State I
ZIP �-- Telephone__
4. Architect/Designer's Name Last I, First F_ Lic. No. �-----I
Architect/Designer's Address
Architect/Designer's E-mail Address
City �
State �-
Zip F_ Telephoner
5. Engineer's Name Last
First F Lic No.
Engineer's Address
Engineer's E-mail Address
City
State F
ZIP ��— Telephoner
6. Contractor's Name Last First l tet 11 ( Lic. No. 64 mClass !b
Contractor's Address
N j Contractor's E-mail Address
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City (� 6 e _, . �� f1
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State r
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zip 5 Telephone�56
ONLY
PERMIT NO.
LOFFICESE
CONSTRUCTION
PLAN CHECK Nn iNCY
- GROUP
PLAN CHECK FEE $