HomeMy WebLinkAboutX2018-3825 - Permit Application (2)Please print 3 copies
Associated Building Permit # F
1. Project Address (Not mailing address)
Tenant Name
2. Description of Work
Extg Sq Ft \� — — -- New/Added Sq Ft
City of Newport Beach - Building Division
New Add j Alter F Demo
Check Appropriate Box for Applicant/Notification
u
FL011- 05&7
Sprinkler j- Fire Alarm F" Fire Misc
Floor FSuite __
# Units
Use
Valuation $ O6
Total Sq Ft ; 2 �b .
# Stories
er's Name Last
FirstdressOwner's
FOwners
E-mail Address
State ��
Zip Telephone
F 4. Architect/Designer's Name
Last First �� Lic. No.
Archiitectt(Desig`ner's Address
Architect/Designer's E-mail Address
State �`
Zip [_ Telephoner �
F 5. Engineer's Name Last
F
____ First
Lic. No.
Engineer's Address
Engineer's E-mail Address
City F
State F_
ZIP [_ Telephone
" t
F 6. Contractor's Name Last
Contractor's
First Lic. No. Class
Address
Contractor's E-mail Add s
City _. `�cs��
State
....�..___..�._.
Zip G pr .. 6 � ..__ Telephone
1
�` ,�� PLAN CHECK NO
77j7�ff\ PERMITNO.
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►� PLAN CHECK FEE $