HomeMy WebLinkAboutF2022-0010 - Permit Application" '-Workst edt for°Fite Permit Application US,
City of Newport Beach - Building DivisionPlease print 3 copies �p
Associated Building Permit # Fire Sprinkler l Fire Alarm j— Fire Misc
1. Project Address (Not mailing address)
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Tenant Name I k(AkoWgb V�n) , ncc
2. Description of Work
Extg Sq Ft New/Added Sq Ft l' 6oq Total Sq Ft
VNew F_ Add r Alter F- Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
# Units r (
Use IZLSiC`C�� G,
Valuation $ nZ
# Stories
[- 3.Owner's Name Last i_
First F—'
Owner's Address
Owner's E-mail Address
City
State F
Zip Telephoner
r 4. Architect/Designer's Name Last
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First �� n� Lic. No. �—
Architect/Designer's Address
Architect/Designees E-mail Address
City �—
State �',
Zip Telephonel—
F 5. Engineer's Name Last
First Lic. No.
F—
Engineer's Address
Engineer's E-mail Address
City
State F
Zip �^ Telephone—
6. Contractor's Name Last QOVS` �f First Lic. No. _ �" lassF—
Contractor's Address
Contractor's E-mail
//Address
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City
State �—
Zip �— Telephone
OFFICE USE ONLYI
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/�PERMIT NO.
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TYPE OF CONSTRUCTION
PLAN CHECK NO. J
OCCUPANCY - GROUP
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PLAN CHECK FEE $
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