HomeMy WebLinkAboutF2022-0001 - Permit ApplicationWoMgheet forfire Permit Application
Print Form City of Newport Beach - Building Division
Please print 3 copies � I
Associated Building Permit # /n ' i Ce Sprinkler j— Fire Alarm r Fire Misc
1. Project Address (Not mailing address) Floor f Suite No
j V ill- C p— 5Tf16G0 F
Tenant Name �,� s'��i # Units �-
2. Description of Work
Extg Sq Ft 3i 2 New/Added Sq FtTotal Sq Ft
r New ✓Add F_ Alter j— Demo
Check Appropriate Box for AppIicant/Notification
Use I �,1�vzj� r4
g-31 0
Valuation $ 6o o
# Stories /
Infowmatmon
F_ 3. Owner's Name Last fj 5��''D/
First _t37
Owner's Address
Owner's E-mail Address
`3 Lr�- c�sT�rlla
City 5 � 6o L o/,F
State C
Zip j— / Telephone '' '�'VS
F_ 4. Architect/Designer's Name
Last
First Lic. No. F
Architect/Designees Address
Architect/Designer's E-mail Address
City
State F_
Zip �-� Telephone
F_ 5. Engineer's Name Last
First F- -� Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State F_
Zip F Telephoned
F 6. Contractor's Name Last (fu-I-/6jr)0eZ First �1; Lic. No. /o�-7rrp1 Class
Contractor's Address
Contractor's E-mail Address
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i .F Cair-- - PAMEF b(, � vz i Ct
City I L/+ /-//1
State L,�
Zip �' �Ej3� Telephone $�Z-7/2-7j�/gZ
OFFICE USE ONLY
PERMIT NO. e7 — O
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $