HomeMy WebLinkAboutF2021-0153 - Permit Application`VVbrlC6he�4orFife�P&M Application n
Print Form
City of Newport Beach - Building Division
Please print 3 copies F Lov 40"A.
Associated Building Permit # Fire Sprinkler Fire Alarm (-j Fire Misc
1. Project Address (Not
2&1Uz co
Tenant Name r-
2. Description of Work
ON 5F\ ll U nL yr-a o m
IN At f✓ �FTrcEF_ ti/<U__W SVS[��AA_ 16_08_ADS
Extg Sq Ft New/Added Sq Ft �j��p f Total Sq Ft
New r Add r- Alter r Demo
Check Appropriate Box for Applicant/Notification
Floor Suite
#Units
Use I ILZNT/�L
Valuation $ ` S-0
f- 3. Owner's Name
Last— First
Owner's Address
Owner's E-mail Address
City �
State F__ Zip Telephoner
4. Archite Designer's Na a Last First Lic. No.
1 ' 1
F
Architect/Desi er's Addre
Architect/Designer's E-mail Address
City
State F Zip F__ Telephoner
r 5. Engineer's Name
Last First Lic. No.
F—
Engineer's Address
Engineer's E-mail Address
City
State Zip F Telephoned
ci6.Contractor's Name
Last 14UFirst KLT Lic. No. Class FcjL
Contractor's Address
Contractor's E-mail Address
ZZ1�72l�M� a
ST D/y _ %oC77ACCSTst✓��GvalG
City F::Vnb5� State - Zip R 36 Telephone pl _64;f -6/6/
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION s^PLAN CHECK NO.
GROUP�� 2V' �2_
OCCUPANCY-
PLAN CHECK FEE $