HomeMy WebLinkAboutF2019-0571 - Permit ApplicationWorksheet for Fire Permit Application
Print Form City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # j Fire Sprinkler X Fire Alarm F_ Fire Misc
1. Project Address (Not mailing address) FloorSuite No
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Aveve. rI FO
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Tenant Name I f m # Units
2. Description of Work
City I
CM6r
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U
14
Extg Sq Ft � New/Added Sq Ft �� Total Sq Ft
Valuation$ 6 U00
Architect/Designer's E-mail Address
# Stories
New Add Alter (� Demo
(1 _ A —S7 VJ
Check Appropriate Box for Applicant/Notification
F_ 3. Owner's Name Last
First
Owner's Address
Owner's E-mail Address
City I
State F_ Zip Telephonel�
F_ 4. Architect/Designer's Name
Last First F_ Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State Zip Telephoned
X 5. Engineer's Name Last
C—pedr e Firstt d),n Lic. No. 75j 11
Engineer's Address
Engineer's E-mail Address
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I0~1 Wepra{�cf� llcam�?
City Say 4g, Fe Sp r ink S
State C� — Zip 90670 Telephone Q`1 03
50 1 (� 6
X6. Contractor's Name Last C—I2d ( Q First l C)no\ Lic. No. 175097 Class' ' C1 0
Contractor's Address
Contractor's E-mail Address
for -4 weef0+ 'Al1,co�
City I SHrl R Fe Sp i n 5
State Zip96�10 Telephone s6q �y 35 6
OFFICE USE ONLY
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PERMIT NO. 7' /�J(/ 65
TYPE OF CONSTRUCTION
29
PLAN CHECK NO. 0
OCCUPANCY - GROUP
PLAN CHECK FEP $