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HomeMy WebLinkAboutF2019-0129 - Permit Application0501440IR �7K) 0lR9 Worksheet for Fire Permit Application City of Newport Beach - Building Division Please print 3 copies D Associated Building Permit # I_elfl(i Fire Sprinkler Fire Alarm Fire Misc 1. Project Address (Not mailing address) Floor No (S.�uite oo 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 �- _ ---- 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 $