HomeMy WebLinkAboutF2019-0085 - Permit ApplicationPlease print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
r Fire�rinkler�F lI Fire Alarm _(_'tire Misc
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1. Project Address (Not mailing address) f"g �v Floor Suite No
0 13 i(cA St. S e.• '100 e Doo t. 0 ([---
Tenant Name I cx---.... _ _..,�; /r'� ... __..� #Units
2. Description of Work
Use
114f 1,4o /i%..r„` L'2,r'�rtQ / 88
Valuation Qd v
Extg Sq Ft New/Added Sq Ft 7-7 Total Sq Ft �I ---
F7 New F_ Add r Alter F_ Demo # Stories
Check Appropriate Box for Applicant/Notification III
3. Owner's Name
Last First
Owner's Address
Owner's E-mail Address
City �—
Stater -
Telephone
Zip I F—
r 4. Architect/Designer's Name Last � !First F Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City �—
State F Zip r Telephone
[', 5. Engineer's Name
Last First— Lic. No. r--_--;
Engineer's Address
Engineer's E-mail Address
City �—
State - Zip Telephone(-
�'! 6. Contractor's Name Last �� / First Vim/ Lic. NoIC Class �/
Contractor's Address
Contractor's E-mail Address
/33� _ a�.e
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_Vacaa ,pri' le. ��e mai .cvm
City �/� Lo
State — Zip Telephone 1. _ 71il�gaj/3
OFFICE USE ONLY
S:34.1,331 P RcMIT NO. Q
TYPE OF CONSTRUCTION
OCCUPANCY
PLAN CHECK NO.
�1 gS�,l° Iw
- GROUP
PLAN CHECK FEE $
17 z.m1 CA • O�`l