Loading...
HomeMy WebLinkAboutX2021-1389 - Permit Application (2)Print Form Please print 3 copies Associated Building Permit # sneet Tor rlre Permit Application City of Newport Beach - Building Division R�' _ l� F_ Fire Sprinkler � Fire Alarm f- Fire Misc 1. Project Address (Not mailing address) Floor Suite No Dob Mot;Aurg, p1uc!_ 1 l57 _ llo Tenant Name I& T Heal pkof # Units 2. Description of Work Owner's E-mail Address Use Frc MAVrh/ L V V Extg Sq Ft r--_---_-! New/Added Sq Ft 3i g�j�j Total Sq Ft I----.---.- Valuation $ i ivsv -- (" New Add �', Alter Demo # Stories f ' Check Appropriate Box for Applicant/Notification Infn,m.fl�. F_ 3. Owner's Name Last I uCT /Vlfdr��i l (fin �Yt First [-------- Owner's Address Owner's E-mail Address l01 - v tWC I7YwC __ Sa�12 City ©fgnot _ State G p Zip . yZ01AQl Telephone iiy-%Lq(v -302- F_ 4. Arch itect/Designer's Name Last I A -y j� %CV I O First /rSdUc(a%�J' Lic. N< Architect/Designer's Address - ,. Architect/Designer's E-mail Address �700 1� H�,rtloC Did CM(lplell.Yoo L City /, )1(efMd ... _.i State--. Zip 1 �5_. Telephone 711— af-/97a- F_ 5. Engineer's Name Last------ First Lic. No. I Engineer's Address Engineer's E-mail Address City_._. _.. _... State F --_-- Zip^--.-.---_.._ Telephoner [ 6. Contractor's Name Last SArn p 6{S Desi yOevt First -- -- - Lic. No. F__ Class Contractor's Address Contractor's E-mail Address City .State F__ --_..--_ Telephone�-__— zip .... OFFICE USE ONLY PERMIT NO. ` O33S TYPE OF CONSTRUCTION PLAN CHECK NO. `7 t OCCUPANCY - GROUP /�� `` _ r �!i/ l PLAN CHECK FEE $