HomeMy WebLinkAboutF2021-0315 - Permit ApplicationCity of Newport Beach - Building Division f 7.tiZ1 a �1I S
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Please print 3 copies ��
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F.,Fire Sprinkler Fire Alarm [�;Fire Misc
Associated Building Permit 1
1. Project Address (Not mailing
Tenant Name
n i7l't,
b Suite No
1756-1
S >6 / _17__1 FX
# Units I - -i
2. Descriptions of Wo�rk / �g�
AVI'r 1 �/1 AJ o W Use
Valuation $ !. 3Q--.-
Extg Sq Ft New/Added Sq Ft Total Sq Ft
#Stories
n New rJ Add F-1 Alter n Demo FI
Check Appropriate Box for Applicant/Notification
Info mat* -n
3. Owner's Name
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Last f, y ,AJ
Owner's Address
Owners E-mail Address
City ✓I° ��/I�'_
..------_. State�I ZiP .... T� (� _ Telephone._`
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F -j 4. Arch itect/Desig ner's Name Last First j LicNo.�—
Architect/Designer's Address
Architect/Designer's E-mail Address
City s
State �— Zip Telephones�J�
5. Engineer's Name
LastFirst __ -lc�� Lic.No.
Engineer's Address
'Engineer's E-mail Address
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City --�'V;7t_? �..--------�-1
State L _; Z'i�P, .. Telephone
❑6. Contractor's Name
Last �� �F rhsil�t Lic.NNoo7F class
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Contractor's Address
Contractor's E-mail Address -- -
City �—
.I State -� ZiP F_ Telephone f0V, -
;F CD 3>U5
OFFICE USE ONLY
PERMIT NO.
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TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $