HomeMy WebLinkAboutF2021-0147 - Permit ApplicationTint
,?City of Newport Beach -Building Division
ase 3 copies '� �2 � . p ILA I
ssociated Building Permit #f7I Fire Sprinkler FI Fire Alarm r7 Fire Misc
1. Project Address (Not mailing address)
Tenant Name
2. Description of Work
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Extg Sq Ft New/Added Sq Ft Total Sq Ft
rJ New F7 Add Y\ Alter F Demo
Check Appropriate Box for Applicant/Notification
U41,1,
-...-Floor
Suite No
# Units'
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Valuation $
# Stories I . "
3. Owner's Name Last[ 1 �� N (0, First
Owner's Address Owner's E-mail Address
city �� ' State I J Zip FT�TTelephoned
4. Architect/Designees Name Last �— First Lic. No.
I
Architect/Designer's Address Architect/Designees E-mail Address
city StateJI Zip Telephone
(° 5. Engineer's Name Last V First Lic. No.
Engineer's Address Engineer's E-mail Address
city-- /. /, -
r. /i State Zip jQ j Telephone -3 ` 4D
6. Contractor's Name Last`10 ` pqw N irsY Lic. No. �! ClassFi,
Contractor's Address Contractor's E-mail Address
City
StateZipZip—'I Telephone—
OFFICE USE ONLY PERMIT NO. �iyroLp(- UUiT k
TYPE OF CONSTRUCTION PLAN CHECK NO
OCCUPANCY - GROUP PLAN CHECK FEE $ �''� Ito