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HomeMy WebLinkAboutF2019-0644 - Permit ApplicationPrint Form Please print 3 copies Associated Building Permit # Worksheet for Fire Permit Application City of Newport Beach - Building Division —� ,�J Fire Sprinkler ❑ Fire Alarm ❑ Fire Misc 1. Project Address (Not mailing address) Floor Suite No -_�� � 6v1G 4tiu'f �1V�4_- — _ F `G� Tenant Name �L-w._ i I i Tj J '— 1 # Units I I II 2. Description of Work Use �� jdjV tl Valuation $ .21 y5 d ❑ 4. Architect/Designer's Name Last—� Y'P- SQY iV{Y lk'r' ""F- I . I 1 41itG1 G�S Architect/Designer's Address Extg Sq Ft . ^�jl C1 New/Added Sq Ft Total Sq Ft Fp (U 5 79 ❑ New FAdd L7 Alter ❑Demo # Stories Check Appropriate Box for Applicant/Notification ❑ 3. Owner's Name Last— First F Owner's Address Owner's E-mail Address City - -- State F-7 zip[ ----7 TelephoneF77—:77 ❑ 4. Architect/Designer's Name Last—� First �— Lic. No. F77 Architect/Designer's Address Architect/Designer's E-mail Address —77 City State Zip Telephoned ❑ 5. Engineer's Name Last �— First E77-71 Lic. No. Engineer's Address Engineer's E-mail Address City State I Zip Telephoned P�6. Contractor's Name Last (It. ' First �Lic. No. Class CIU �l Contractor's Address Contractor's E-mail Address Inc, ❑- YYykA arye� �ci��PICa Fihc��Affitii�iyS� Gcvv� City `(+yt �a-y� g� State Zip Telephone OFFICE USE ONLY PERMIT NO. TYPE OF CONSTRUCTION PLAN CHECK NO. 41L -Q OCCUPANCY- GROUP --�oIf'n PLAN CHECK FEE $ 22506141 yutq.txj'1