HomeMy WebLinkAboutF2018-0036 - Permit ApplicationFes« -row
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Fire Sprinkler [ Fire Alarm n Fire Misc
1. Project Address (Not mailing address) Floor Suite No
# Units
Tenant Name ¢r,c,�,'t,p %,s.="�.a'.°qF�'_
2. Description of Work
Use
vp
B
Extg Sq Ft "t '�t✓r New/Added Sq Ft F Total Sq Ft 1+N, r" °x"
Valuation w x�
F_/New [—••• Add r Alter r Demo
#Stories
-
V `l/
Check Appropriate Box for Applicant/Notification
F 3. Owner's Name Last fg,p ia4 a First
Owner's Address Owner's E-mail Address
City -. . • 4�'�' q+kaki State t„1. Zip Telephone—
�- t/Designer's Name st - First �%j,4�/'e-. _ .. Lic. No.
F_
ArchitecUDesigner's A dress Architect/Designees E-mail Address
City I ', State F Zip F Telephoned
[- 5. Engineer's Name Last First� Lic. No.
F
Engineer's Address - Engineer's E-mail Address
City State Zip F_ Telephone
r 6. Contractor's Name Last .tj ,,. Fi stF Lic No. �+�' Class"��s,
Contractor's Address Contractor's E-mail Address
._..M14,tt�=v Telephone[
City ,al°^"r„@r State d..W.. Zip P
s ..._-
OFFICE USE ONLY "• PERMIT NO. LOJ
TYPE OF CONSTRUCTION >' PLAN CHECK NO.
OCCUPANCY- GROUP D -2A6)1 (e C)_TU PLAN CHECK FEE $