HomeMy WebLinkAboutF2019-0337 - Permit ApplicationPrint Form �:Zon
Please print 3 copies V
Associated Building Permit#
Worksheet for Fire Permit Application
® ' 1 City of Newport Beach - Building Division l I
P'Fire Sprinkler r Fire Alarm
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FFire Misc
1. Project Address (Not mailing address) Floor Suite No
350 JAMbOftt Koa_ k-LA00 (oiaa'
# Units _.........--.......
Tenant Name SoIY'�S �e9�S
2. Description of Work
City
In
T(vt io SPr��<ier '• _ ��S t/�II new
Use
Extg Sq Ft New/Added Sq Ft Total Sq Ft 710 5
Valuation$
Architect/Designer's E-mail Address
# Stories
F' New K Add F_Alter (— Dema
City II VYU/ t,
Check Appropriate Box for Applicant/Notification
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F_ 3. Owner's Name Last
First
Owner's Address
Owner's E-mail Address
City
State Zip TelephoneF
I— 4. Architect/Designer's Name
Last VISWOI U First Jay fed Lic. No. ,
Architect/Designer's Address
Architect/Designer's E-mail Address
Ibisvpl�.I�gyw� aR
,Jayfo _ 61 pmc-Ico
City II VYU/ t,
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State c`A Zip qZU(05 Telephone'��i b'52'�(p 1�
F_ 5. Engineer's Name Last
First I — Lic. No. F
Engineer's Address
Engineer's E-mail Address
City
State I— Zip �', Telephone
j 6. Contractor's Name Last
Q�'vy, First F Lic. No. 95,46 Class 0�Q
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IY� Or `
Contractor's Address
Contractor's E-mail Address
"Inl W Yw� a11�C&ACle
9u�?IV� •UNA
City
State I CA � Zip q2." Telephone',
OFFICE USE ONLY�1
S/�S��///���J�`"`���44°2`�"" � , !n �¢ / PERMIT NO. I r
TYPE OF CONSTRUCTION
/ h PLAN CHECK NO. 2 /
OCCUPANCY- GROUP
! J PLAN CHECK FEE $