HomeMy WebLinkAboutF2020-0282 - Permit ApplicationPlease print 3 copies
Associated Building Permit #
1. Project Address (Not
do°OaRr
Worksheet for Fire Permit Application � m
City of Newport Beach - Building Division
9� t�� s3 a20�02�2
Fire Sprinkler [ Fire Alarm r Fire Misc
address) ` Floor
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Tenant Name o k ie-esiA,,t ( -C #Units
2. Description of Work
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Extg Sq Ft F Ne /Added Sq Ft 4/ / -71.7Z, Total Sq Ft31� Z
I—' New F- Add r Alter F- Demo G q
Check Appropriate Box for Applicant/Notification
Suite No
Use
U
Valuation $ ()C)
E
Ston
L) FS
F 3. Owner's Name Last
First [_
Owner's Address
Owner's E-mail Address
City State F
Zip Telephoner
r- 4. Architect/Designer's Name Last
First F Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City State F
Zip F Telephoned!
r, 5. Engineer's Name Last I First F Lic. No. F
Engineer's Address
Engineer's E-mail Address
City State r
Zip F Telephoner
6. Contractor's Name Last FirstLic. No. 2S/S2 Class b
Contractor's Address
Contractor's E-mail
e rf GrFIS f °U 9 Ce .t h'a i y-1
nAddress
City no State ��
Zip q_ (71 p Telephone S62 �l9 7t(�j
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OFFICE USE ONLY
PERMIT NO. V --.O ZC� O'
TYPE OF CONSTRUCTION
PLAN CHECK NO. J 11 �> ' Z_0 Z_0
OCCUPANCY- GROUP
^ Oi?PJ-% PLAN CHECK FEE $