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HomeMy WebLinkAboutF2016-0473 - Permit ApplicationWorksheet for Fire Permit Application y% City of Newport Beach - Building Division t Please print 3 copies f 61 -3 �9 Associated Building Permit # F r, Fire Sprinkler UV..: Fire Alarm F-; Fire Misc 1. Project Address (Not mailing address) Floor Suite No 59 ! # Units Tenant Name 2. of Work State Zip[ Telephone �D,e�scrription l"^"� 7�fi�p/.L c=/' ��lS'��/xlCi %�1Cl�l nt7/ DD�%d7 Use Architect/Designers Address Architect/Designers E-mail Address City Valuation $ Extg Sq Ft New/Added Sq Ft F Total Sq Ft F Firstr Lic No, F -Add # Stories New F r Alter [-Demo Check Appropriate Box for Applicant/Notification ( / 3. Owner's Name Last First Owner's Address Owner's E-mail Address City _-. State Zip[ Telephone F_ 4. ArchitecUDesigner's Name Last First F Lic. No. F Architect/Designers Address Architect/Designers E-mail Address City State F. Zip Telephoner (- 5. Engineer's Name Last Firstr Lic No, F Engineer's Address Engineer's E-mail Address i City State Zipr— Telephone F 6. Contractor's Name Last r First 376ve Lic No F1778(0 Class 42-(,'O <C0131 li / W666,qM--xC RAE r 7xW7 Contractors Address ontractor's E-mail Address / co A-1 3%n2_e City ii3/_n3 0% // State Zip % Telephone ��.0 - _ JL_' 2-. 022 C OFFICE USE ONLY PERMIT NO. 1/0 01 �r TYPE OF CONSTRUCTION HECNOV �}) PLAN CHECK NO' V OCCUPANCY- GROUP 0 PLAN CHECK FEE $ SCD7. c9a