HomeMy WebLinkAboutF2019-0129 - Permit Application0501440IR
�7K) 0lR9 Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
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Associated Building Permit # I_elfl(i Fire Sprinkler Fire Alarm Fire Misc
1. Project Address (Not mailing address) Floor No
(S.�uite
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Tenant Name (U # Units
IIII
2. Description of Work
City
Use
T�Slull ) 5 `'941 of Si/dyes C,,J
i
First�tik az,Lic. No.
Valuation $ U vp
Ext S Ft �, J G U New/Added S Ft ,1� Total S Ft 2 3 6
9 Q Q �V(CT !_ 4 U
/- --
/
'
Stories
r-Newr Add (p Alter F_#
Demo
F-, 5. Engineer's Name Last Q� �..- _ First Lic No.l
II
Check Appropriate Box for Applicant/Notification
(-: 3. Owner's Name Last
t F_
Owner's Address
Owner's E-mail Address
City
Zip � Telephone�—
4. Architect/Designer's Name Last �� �f r,n
First�tik az,Lic. No.
Architect/Designer's Address
Architect/Designers E-mail Address
vofv�^- -�,.e ke�y4rrti �-
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F 11 E. Fr,,J S�l-.
City Sc„ �)'h � k State (•,_ - -
YY
Zip t�Z7o � Telephone } ujy_-.-Din
F-, 5. Engineer's Name Last Q� �..- _ First Lic No.l
II
Engineers Address
Engineer's E-mail Address
City � _ .-_ - State F_.
Zip F— Telephoned-
F-6. Contractor's Name Last :" 1z c� 'e� First— Lic.No. S G (� Class to-iG h
r� �i7 `
Contractors Address
Contractor's E-mail Address
176 Fiv
-t—
City ,�, _...�-� State F
Zip 1 Gl Telephone 7H p A � � XUp
OFFICE USE ONLY
PERMITNO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.�!
OCCUPANCY -GROUP
/ / PLAN CHECK FEE $