HomeMy WebLinkAboutF2019-0444 - Permit Application�3��
Worksheet for Fire Permit Applica on ,t �q°�"r
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City of Newport Beach - Building Division
Please print 3 copies
Associated BuildingPermit # V I e Al Ar� 3
r' Fire Sprinkler (— Fire Alarm r Fir c
t. Project Address (Not mailing address) Floor Suite No
Leo S- /�" ��,s�o �- 8/vc' F3 I--
Tenant Name I # Units I Z
2. Description/of Work
1� 11/`C�'I/ �� p �!✓C /y,� F4Gr Use
IA( .
�, Valuation $
`p��-r'Z `.
Extg Sq Ft mow/Added Sq Ft Total Sq Ft
New F_ Add # Stories F -
r Alter j— Demo
Check Appropriate Box for Applicant/Notification
(— 3. Owner's Name Last
First
Owner's Address
Owner's E-mail Address
City I
State F_ Zip F— Telephoned
yl4. Architect/Designer's Name
'� �\Architect/Designees
Last %b � / First � 4 Lic No. �—
/ ' Sj
Address
Architect/Designees E-mail Address �8 3 `d
lr - _
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City S��^
State I ` , Zip ��_. Telephone
C
i- 5. Engineer's Name Last
First— Lic. No. r
Engineer's Address
Engineer's E-mail Address
City _
State F Zip Telephonef
F 6. Contractor's Name Last 2q First Lic. No. r�7�q?Class
�/�t .-
Contractor's Address
Contractor's E-mail Address
3/y2 /, �s";"
[-Z) 49 rF'sc-. �9���'^R t �a
City ` U�,s
State �ej Zip ��4"7cj Telephone i(J
OFFICE USE ONLY
TYPE OF CONSTRUCTION
/ PERMIT NO.
"7 PLAN CHECK NO.
OCCUPANCY - GROUP
�� 3 PLAN CHECK FEE $