HomeMy WebLinkAboutF2022-0492 - Permit Application'; Pr:aYFo�m
Please print 3 copies
Associated Building Permit #
vvortcsneet ror rlre rermtt Application ARY
City of Newport Beach - Building Division Cj
_2.021 ❑ Fire Sprinkler ❑' Fire Alarm R�FireMisc
1. Project Address (Not mailing address)
Tenant Name QC CtiLl I L1T
2. Description of Work
Extg Sq Ft F-7-71 New/Added Sq Ft Total Sq Ft
❑ New P Add ❑ Alter ❑ Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
[�7] 4v3
# Units
Use
Valuation$ 170 ODp
# Stories t
❑ 3. Owner's Name Last�MpAtJ��ru First
Owner's Address
Owner's E-mail Address
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SmG c�uezmi P(3CFeart,l;fi-t .earn
City Ne�ppokT r3je(}C,N State Fe�7
Zip 2G C Telephone Clt{�_7L�6-222
❑ 4. Architect/Designees Name Last so k_)(Aacr First ` h Lic. No.O
Architect/Designer's Address
Architect/Designer's E-mail Address
S�y°nC�erS � w'.a� A�r�h��ec�s
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City I lJet_..)Pz-yR-V State
Zip Telephone
❑ K 5. Engineer's Name Last Cj u (Z First Lic. No. 6T30US54Z
Engineer's Address
Engineer's E-mail Address
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sno�r@ c,bsc�l��2Co.COw�
City n pQ(ZT >?jE(�C{{ State
Telephone gLtot
—Zip
❑6. Contractor's Name Last ��p� tJ
First �.�5� n Lic. No. (Q3Pj�j(j Class
Contractor's Address
Contractor's E-mail Address
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�^Qc�r� �rmC�tS}ruC t\-USC
City State L�
Zip C1 �(�`t l Telephone �l-t{/{d-qQ
OFFICE USE ONLY
PERMIT NO. F W22- 04 R Z
TYPE OF CONSTRUCTION
PLAN CHECK NO. PW-V ZoZZ- L66 5
OCCUPANCY - GROUP
PLAN CHECK FEE $