HomeMy WebLinkAboutF2021-0134 - Permit Applicationv ,WbTk§h)beffdr-Fire Permit Application
"Print Form City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # I F_ Fire Sprinkler fire Alarm
F_ Fire Misc
1. Project Address (Not mailing address) Floor Suite No
+IJ 115� PAC AMY COL`` _ F `� 7,6L�
Tenant Name I�Ul�Y # Units—',
22.. Denscription of Work
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Use 1�
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Extg Sq Ft New/Added Sci Ft Total Sq Ft �� •jam? 1
Valuation $ 21 3��-'n C; r?
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r New r AddAlter F - Demo
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Check Appropriate Box for ApplicantlNotification
F 3. Owner's Name Last l' First F_
Owner's Address
Owner's E-mail Address
City FT \ v,Vtk _
State Zip TelephoneCAF—
F 4. Architect/Designees Name Last First F Lic. No. F
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State F_ Zip Telephone
F7! 5. Engineer's Name Last i First Lic. No.
Engineer's Address
Engineer's E-mail Address
City l
State Zip Telephone
F 6. Contractor's Name Last
Tit A 1 �� First { Lic. No. `� utefo� Class C, to
V
Contractor's Address
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Contractor's E-mail Address
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City �}/\(�v�.
State Telephone
OFFICE USE ONLY
4 PERMIT NO. 't-° .
TYPE OF CONSTRUCTION
/I '-oZCi:i PLAN CHECK NO.0 1ZZ'
OCCUPANCY- GROUP
t'q ,% PLAN CHECK FEE $
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