HomeMy WebLinkAboutF2018-0299 - Permit Application2,0ff ()2_q q
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
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Associated Building Permit # �— I Fire Sprinkler F. Fire Alarm (^ Fire Misc
1. Project Address (Not mailing address)
Floor Suite No
X35 _Sq �aeiut�_-
-
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Tenant Name
F_ 4. Architect/Designer's Name Last P First Lic. No.
# Units
2. Description of Work
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-.-_- - -' State - C /7 Zip '�I I t�_._. Telephone l G t ! attU-.OI / 7
f— 5. Engineer's Name
f e S'i�tiC�2 Ys
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Engineers E-mail Address
Use
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State F Zip [7777 Telephone 7-7
F6. Contractor's Name
Last l r ,�V Son0 �� First Lic. No. G0 Class W—'
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Valuation $7�OGp�._.
Extg So Ft
New/Added Sq Ft Total So Ft
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State Zip , a Telephone l
cA_ I �R72 7 Y 3i070[�
OFFICE USE ONLY
S-01Ql. 029q
PERMIT NO. FS-01%-
# Stories
F- New F_ Add
I— Alter F_ Demo
- ---
Check Appropriate Box for Applicant/Notification
ri 3. Owner's Name
Last - of 5eq First aYtO �
Owner's Address
Owners E-mail Address -
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City F_—
-.. _ State Zip Telephone d',.
F_ 4. Architect/Designer's Name Last P First Lic. No.
Architect/Designees Address Architect/Designers E-mail Address
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-.-_- - -' State - C /7 Zip '�I I t�_._. Telephone l G t ! attU-.OI / 7
f— 5. Engineer's Name
Last First' Lic.No.�
Engineer's Address
Engineers E-mail Address
City
State F Zip [7777 Telephone 7-7
F6. Contractor's Name
Last l r ,�V Son0 �� First Lic. No. G0 Class W—'
�" Y
Contractors Address
Contractors E-mail Address
Q593 VrcFdvr'9✓�.
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city - cq-
State Zip , a Telephone l
cA_ I �R72 7 Y 3i070[�
OFFICE USE ONLY
S-01Ql. 029q
PERMIT NO. FS-01%-
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TYPE OF CONSTRUCTION 1[l�t�i�I • �5 PLAN CHECK NO. ,���(g
OCCUPANCY - GROUP
�(.�pj-t ���jj PLAN CHECK FEE $