HomeMy WebLinkAboutF2018-0572 - Permit ApplicationPrint Form` "
Please print 3 copies
Associated Building Permit #
�ZD «V - U -5'12 -
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
��_ �❑ Fire Sprinkler ❑ Fire Alarm ❑ Fire Misc
1. Project Address (Not mailing address) Floor Suite No
F-7 E777
_�fkOJ__L.�•��--------
I�
Tenant Name ���' # Units L
—J
2. Description of Work
Z C— 5�c,�_
Use
❑ 4. Architect/Designer's Name Last First Lic. No.
I
Extg Sq Ft New/Added Sci Ft Total S _Ft
valuation $ 3 �+
3#
F7 New ❑ Add ❑ Alter ❑ Demo �j
Stories
Check Appropriate Box for Applicant/Notificatio
❑ 3. Owner's Name Last . FirstFutm�,V_
Owner's Address Owner's E-mail Address
Z C— 5�c,�_
_ _
City _ _ l �_ State T6Zip F7__7 TelephoneF77777:7
❑ 4. Architect/Designer's Name Last First Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City I State F77 Zip Telephoned
❑ 5. Engineer's Name Last First Lic. No.
Engineer's Address Engineer's E-mail Address
City — _ State [� Zip F77:1 Telephoned
❑ 6. Contractor's Name Last qJ First 11 I a } Lic. No. F76� Class
Contractor's Address Contractor's E-mail Address
City ��State FCA-71Zip V 6)(�Telephon`e
OFFICE USE ONLY PERMIT NO. «
��
TYPE OF CONSTRUCTION PLAN CHECK NO. Z-1,50�0
OCCUPANCY - GROUPf i D ti 'S PLAN CHECK FEE $