HomeMy WebLinkAboutF2022-0463 - Permit ApplicationworKsneeL ror sire rermit Application o m�
Priri`t.Form ; City of Newport Beach - Building Divisio i
L%oZ�� D� 2 00.Ht
Please print 3 copies ( V J
A«nriated Buildina Permit # ❑ Fire Sprinkler ❑ Fire Alarm ❑ Fire Misc
Tenant Name
n n.. n4inn of Wnrk
dNew ❑ Add ❑ Alter ❑ Demo
Check Appropriate Box for Applicanvrvo><iricaiion
❑ 3. owner's Name Last I rvi oz Cc
Owner's Address
City I I State
Floor Suite No
# Units
Use
Valuation $ L ��
# Stories
First
Owner's E-mail Address
Zip Telephoned
❑ 4. Architect/Designer's Name Last First Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State Zip Telephoned
❑ 5. Engineer's Name Last -- J First Lic. No.�
Engineer's Address
City J State
f6. Contractor's Name Last Ur A K
ontractor's Address
-A .
City Q State
OFFICE USE ONLY
TYPE OF CONSTRUCTION
Engineer's E-mail Address
ZIP [ Telephone��
Firs ` . Lic. No. Class
Contractor's E-mail Ad ress
sew \j co
Zip ga Telephone[ ' , ' ' 777
q
PERMIT NO.
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $