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HomeMy WebLinkAboutF2019-0218 - Permit ApplicationPrint Form ; / _ �A Please print 3 copies r 1/l Associated Building Permit # Worksheet for Fire Permit Application VZkq City of Newport Beach - Building Division r`Fire Sprinkler F Fire Alarm r Fire Misc 1. Project Address (Not mailing address) Floor Suite No Last First Tenant Name �� 2 �C` 9u� Unts 2. Description of Work City State ��' Zip � Telephoned---'. Use �r Extg Sq Ft ��, New/Added Sq Ft I - Total Sq Ft' Valuation $ I Zsbc) —' I` New Add F- Alter F_Demo # Stories State F_Zip I Telephones 5. Engineer's Name Check Appropriate Box for Applicant/Notification F_ 3. Owner's Name Last First Owner's Address Owner's E-mail Address City State ��' Zip � Telephoned---'. r 4. Architect/Designer's Name Last Ly_<<� First C/,' Lic. No. -- Architect/Designer's Address Architect/Designer's E-mail Address City I State F_Zip I Telephones 5. Engineer's Name Last � First F_, Lic No. Engineer's Address Engineer's E-mail Address City State—' Zip Telephone F_ 6. Contractor's Name Last First/ Lic.No. gtZ/'7 Class', C -/6 Contractor's Address Contractor's E-mail Address r�sLed /0 6, ..A2 City ���Jy� �� �� State Zip 6 Telephone glfd_ZC/'3 <( Of1Fl USE ONLY j. -- PERMITNO. 10) _'E F CONSTRUCTION PLAN CHECK NO. ,3C a G U ANCY -GROUP PLAN CHECK FEE $