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HomeMy WebLinkAboutF2021-0390 - Permit ApplicationPlease print 3 copies Associated Building Permit # Ur 1n71. rICl7L IUr r'IrC PCrrnll M Dlic�allon V City of Newport Beacjh'- Building Division -3 11r/Fire Sprinkler F_I Fire Alarm Fire Misc 1. Project Address (Not mailing address) Floor Suite No Tenant Name #Units L 2. Description of }W"o��rk Use �l i 1 nd LEA!' td e 0_cl!� - - Valuation Extg Sq Ft New/Added Sq Ft Total Sq Ft I - - -' - --I + - New r7 Add I-i Alter F-! Demo # Stories Check Appropriate Box for ApplicantlNotification r� t, l 3. Owner's Name Last -J t'��l'��P �('1 ° �I First Owner's Address Owner's E-mail Address 11 f LiNvV®id('' ov-1 city �,� � - - - --.. State FT7 Zip t9 -y TelephoneFET� F_ 4. Architect/Designer's Name Last First Lic. No. _ -' - Architect/Designees Address Architect/Designees E-mail Address City State , Zip [77--7 Telephone[77777 5. Engineer's Name Last ' Y1 ✓ First Lic No. Engineer's Address Engineer's E-mail Address City State F-- Zip Telephone ['6.Contractor's Name Last (tI ! First —; Lic. No. ��1 �Class Contractor's Address Contractor's E-mail Address ZZ�iG� JoC.E+��c`� City lb, j/) 17W.7 ' U, . -.-. - State Zip qF I TelephoneR._ L' I ..--ti� OFFICE USE ONLY �vPERMIT NO. ©n • �I TYPE OF CONSTRUCTION PLAN CHECK NO. OCCUPANCY - GROUP PLAN CHECK FEE $