HomeMy WebLinkAboutF2019-0157 - Permit ApplicationPrint Form Worksheet for Fire Permit Application
City of Newport Beach -Building Division
/�
Please print 3 copies l® I� I a ®' G '1 /7
/ -
Associated Building Permit# •JO�� F_ Fire Sprinkler rFire Alarm F_ Fire Misc
U-)
1. Project Address (Not mailing address) Floor Suite No
3)10 _ i4 c IXZ1132 r 110
Tenant Name Aj 1 l �k� -P # Units F v 0
2. Description of Work
Owner's E-mail Address
4 t'/,.
Use
Extg Sq Ft r� New/Added Sq Ft Total Sq Ft F
Valuation $
r4.Architect/Designer'sName
# Stories,
F_ New r Add F_ Alter F_ Demo
Architect/Designer's E-mail Address
Check Appropriate Box for Applicant/Notification
Infnrmmfinn
3. Owner's Name Last
LLNCo1 First',
Owner's Address
Owner's E-mail Address
1$200 VrrnCn_
'i&Lkc Aga
City : _fv( fQe
State I (n Zip I q2b I Z Telephone Iqj 333 2—HI
r4.Architect/Designer'sName
Last l3kje First[ Lic.No.l— — —,
Architect/Designees Address
Architect/Designer's E-mail Address
City I CA,,IVe-C
State � Zip CjaZjd TelephoneF_
F_ 5. Engineer's Name Last
J�V 111 to A First In L Lic. No. '
Engineer's Address
Engineer's E-mail Address
8531 mjtr JIQp �,Je
City A6" W(AVV,,ttinSC`
State 15 zipl5 ,S6 TelephoneF_
6. Contractor's Name Last �i 111S First I— 'Lic. No. �`I �'' Class C( 6
to
Contractor's Address 1`/ SYS ` S _ Contractor's E-mail Address G
b vt^,t
City TU S`I') N
p
State Zip l2 6 Telephone 51� q3,0 7?Zq
OFFICE USE ONLY
TYPE OF CONSTRUCTION
PERMIT NO. _1L A oj5l
•� ��
]�
PLAN CHECK NO.
)�/ 71� b
OCCUPANCY - GROUP
Zat_, •�� PLAN CHECK FEE $