HomeMy WebLinkAboutF2019-0328 - Permit ApplicationF201q-0%�-�:Worksheet for Fire Permit Applicati&n"��%(` °oF e
Print Form
City of Newport Beach -Building Division
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Please print 3 copies 1,V
Associated Building Permit # r G1 _ L( ( F ire Sprinkler F_ Fire Alarm r, Fire Misc
1. Project Address (Not mailing address)
Floor Suite No
Tenant Name Sh
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# Units
2. Description of Work
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.Use ecu o i qg
Extg Sq Ft
New/Added Sq Ft
Total Sq Ft i z�p
Valuation$
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# Stories
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.Alter F_Demo
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Check Appropriate Boz for Applicant/Notification
F_ 3. Owner's Name Last First F
Owner's Address Owner's E-mail Address
City 1 � 'v State— Zip v /nb TelephoneRW j6q q-gto
r 4. Arch itect/Designer's Name Last 111 /iiM� I iFirst �/�if 6 1 Lic. No.
Architect/Designer's Address t'I V ` Architect/Designer's E-mail Address o
City State FCA Zip Telephone
5. Engineer's Name Last1/l/It Dr , First N u ( Lic. No.
Engineer's Address V Engineer's E-mail Address
City (D� State �, Zip Telephone /
F_ 6. Contractor's Name Last �C( j �, Ui/ L7"}J� - — Lic. No. ��(lIy Class', (.J
Contractor's Address j I✓ Contractor's E-mail Address U
City State l Zip /) Telephone l %��j 6tijl ay
OFFICE USE ONLY ! PERMIT NO.�
TYPE OF CONSTRUCTION PLAN CHECK NO. rZ Zt �C
OCCUPANCY- GROUP PLAN CHECK FEE $