Loading...
HomeMy WebLinkAboutF2019-0416 - Permit ApplicationT-2D1q J DA Worksheeor re Permit A lica to Print Form t fFire pp City of Newport Beach - Buil ing Division ���3 Please print 3 copies V/�1n Associated Building Permit # Fire Sprinkler r Fire Alarm/ r Fire Misc 1. Project Address (Not mailing address) 9Lig0 v©Q kN� Tenant Name tilaul- ca-C((� 4" 2. Description of Work afo�6 Extg Sq Ft F New/Added Sq Ft F_ New F Add Alter r- Demo Chnnb A.. _•- n- - - - Total Sq Ft Floor Suite No # Units F— Use I 0Arm Valuation $ F3&o # Stories F 3. Owner's Name Last F First F— Owner's Address Owner's E-mail Address City �— State F— Zip [_ TelephoneF� F_ 4. Architect/Designer's Name Last First �� — Lic. No. �- Architect/Designers Address Architect/Designer's E-mail Address City �— State F— Zip [_ Telephone— r 5. Engineer's Name Last F— First F—Lic. No. F_ Engineer's Address Engineer's E-mail Address City I— State F_ Zip [_ Telephone— r 6. Contractor's Name Last Ar First-_ — irstF� Lic. No. Ft�ss Class TZ �— Contractor's Address \ Conttrracctor's E-mail Address V. 0C9 ��. 1ppp� CGYY� City �QYI ^ State �— Zip q2 6 Telephone 114 1G OFFICE USE ONLY PERMIT NO. : TYPE OF CONSTRUCTION PLAN CHECK NO. I �L2. 2pr OCCUPANCY - GROUP PLAN CHECK FEE $