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HomeMy WebLinkAboutF2019-0630 - Permit ApplicationWorksheet for Fire Permit Applicatii City of Newport Beach - Building Division Please print 3 copies Associated Building Permit # I i ;Fire Sprinkler r; Fire Ala I 1. Project Address (Not mailing address) 1 a7 E. 4PV4 �,--f Aim Tenant Name 2. Description of Work i 1N4;!jWf4 /,CP+ op 6 r,.rpay,r r[-3rYleu`�%�-i SP2i�+IG(21� S.�S't'�-ti-t Extg Sq FtTotalNew/Added Sq Ft Total Sq Ft Pel ? F New j— Add ( Alter F.— Dem Check Appropriate Box for Applicant/Notification (P, . Fe Mis irc # Units Usel •pde�Fcl Valuation $ 4rn'o # Stories 0 r. 3. Owner's Name Last First Owner's AddressOwner's E-mail Address City F_ I State i ZipZip Telephone (` 4. Architect/Designer's Name Last i First �— Lic. No.- ArchitecUDesigners Address Architect/Designees E-mail Address city State-. Zip f -----, Telephoner ' F 5. Engineer's Name Last i First t Lic. No. Engineer's Address Engineer's Email Address City State F_ Zip- Telephonet (�6. Contractor's Name Last First /y/� Lic No. �y�//s Class Contractor's Address Contractor's E-mail Address //¢CAS F/gees --_ bilk0./lii'e�rrrfee.d-;�+,.d�.r_eu'(.cam City _.OiSc v _ `State I "" Zip p,'}CrS'7s Telephone CgVr9)its.;Iy� OFFICE USE ONLY 1 �1 L�:� PERMIT NO. TYPE OF CONSTRUCTION OCCUPANCY - GROUP OlMg6�1 - y� PLAN CHECK NO. G C PLAN CHECK FEE $