HomeMy WebLinkAboutF2021-0541 - Permit ApplicationCity of Newport Beach - Building Division v• U20Please print 3 copies
Associated Building Permit# r 2 Z'O�
C Fire Sprinkler Fire Alarm Fire Misc
I- Project Address (Not mailing address)
[C3 1 g r i t rl A v� Suite No
Floor
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Tenant Name �a n d 4 C x prt `s
# Units
Z. Description of Work
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Extg Sq Ft I tr I �l J New/Added Sq Ft�Valuation $ eo � Total Sq Ft 1
❑ New C Add fik Alter . C Demo # Stories
Check Appropriate Box for Applicant/Notification
Info matin
❑ 3. Owner's Name Last
Owner's Address —I
city 0 S L M R a d State /I b
First /P'A 11 < C x,l.i{, Sr
Owner's E-mail Address
Zip_ 9 17 7 6 Telephone!
C 4. Architect/Designer's Name Last J
Architect/Designers Address
J First Lic.No.�
City State 1-77
C 5. Engineer's Name
Architect/Designers E-mail Address
Zip � TelephoneF
. I_ J
Last �4y1
engineers Address
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City I u M State /l d
C 6. Contractor's Name
First
S Ce d{ Lic. No. i0 y
Engineer's E-mail Address
Zip Telephone !?t,� C
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Last ^^ - i
First <O Lic. No. !a d y Cl
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Contractors Address assC � �----'
City L� /VII A r�r t�l State
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OFFICE USE ONLY
Contractor's E-mail Address
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Zip Gj z tS 2 Telephone 9_s_,( 3 3 4-
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TYPE OF CONSTRUCTION PERMIT NO. � , -
OCCUPANCY - GROUP PLAN CHECK NO.
VZO V_ (���� PLAN CHECK FEE $