HomeMy WebLinkAboutX2021-1299 - Permit ApplicationPlease print 3 copies
Associated Building Permit #
LAnY or Newport Beach nklerach - Building Division
/ 6
/ �t u
✓� .�02A -1 // 1 T1.16
I C-1❑ Fire Alarm ❑ Fire Misc I JL
1- Project Address (Not mailing address) Floor Suite No
Tenant Name ®41 AA,,70
--1" -- 9 ------ - N O # Units I
2. Description of Work ® 1
S Use elS}i 1�
q oU
Extg Sq Ft New/Added S Ft r Valuation $ Foo
r 4'X
Sq [ l J T�4 PP S+ d
❑ New ❑ Add❑Alter MFcCS• C`S
#StoriesDemo HqPt 11A w I
T(/9a,� ,
Check Appropriate Box for Applicant/Notification
1p21• Owner's Name
LastQI c oV 1 L - First GI � Pa
------------ --- --------------
Owner's Address
city E k)/U\ -- — State �� J
r ct/Designees Name
Owner's E-mail Address
ec
Zip -9 ..._ Telephone S/14 Vl__gS43
Last �— First
Architect/Designer's Address
City State
F77
Architect/Designer's E-mail Address
ZIP Telephoned
®11
❑ 5. Engineer's Name Last �!
-- -- -- First — Lic No.� �
Engineer's Address Engineer's E-mail Address
city F7777777777 State � Zip �� Telephoned
❑ 6. Contractor's Name
Last i�1q.V ti5� First 3i tt Ce - 1 Lic. No. 8U, 9S Class[ -i
fY - -
Contractor's Address
city C.05 �PS� - -- I State C
OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY- GROUP
Contractor's E-mail Address
Zip LIju� I Telephone[R )
PERMIT NO. td
PLAN CHECK NO.
FJ___ PLAN CHECK FEE $