HomeMy WebLinkAboutF2021-0349 - Permit ApplicationvvorKsneet for I -Ire Permit Application US,
Print Form City of Newport Beach - Building Division
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Associated Building Permit # AW�Q �lL`� Fire Sprinkler J_ Fire Alarm r Fire Misc
1. Project Address (Not mailing address)
Ido 06*%l N L _
Floor Suite No
F:5 -F3-2,
Tenant Name�
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#Units F,.
2. Description of Work
City
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Extg Sq Ft F—'. New/Added Sq --- Ft � Total Sq Ft F_
Valuation $
F_ New F' Add r
Alter Demo
#Stories'/
Last J y i�, st F Lic. No.
F-
Engineer's E-mail Address
Check Appropriate Box for Applicant/Notification
r 3. Owner's Name
Last 6q y _ c( its e_$irst F_
Owner's Address
Owner's E-mail Address
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City
State Zip Z Telephone
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F_ 4. Arch itecUDesigner's Name Last First f Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State �— Zip Telephone�—
r 6. Engineer's Name
Last J y i�, st F Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State F_ Zip F--.---'. Telephone ---y,
r 6. Contractor's Name Last A-11 . W AVE;-
y � ' First F ---- Lic. No. 6 2 -Class'
Contractor's Address
Contractor's E-mail Address
2-7-310 5rt t�
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City t�L
State � - Zip �%S� % Telephone qG Z U 6 q,D �{o
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OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE
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