HomeMy WebLinkAboutF2020-0007 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach -Building Division �W,20 - QQQ7
Please print 3 copies
Associated Building Permit#�U I J 37 ire Sprinkler [-I' Fire Alarm L7 Fire Misc
1. Project Address (Not mailing address) Floor Suite No
A041 . bn
Tenant Name �`�I�LGI #Units F
2. Description of Work
Use _—
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EMg Sq Ft New/Added Sq Ft l l Total Sq Ft ��
Valuation $ �L��1
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Zip 2(Q (P Telephone �qq - 7qq . / ZJ' C
F_ 4."Arch itect/Designer's Name Last
# Stories
New r Add r Alter F Demo
--
Check Appropriate Box for Applicant/Notification
Infi..m.�Y....
3. Owner's Name Last L L1Vlt��YL
�I First
Owner's Address
Owner's E-mail Address
City � �, State
j
Zip 2(Q (P Telephone �qq - 7qq . / ZJ' C
F_ 4."Arch itect/Designer's Name Last
First I Lic. No. F—
Architect/Designer's Address
Architect/Designer's E-mail Address
i
City State
Zip f --'—� Telephone`
[ 5. Engineer's Name Last !
First Lic. No.
Engineer's Address
Engineer's E-mail Address
City State—.
Zip -1 Telephoned--- �i
F6. Contractor's Name LasttAL1 ry aVY/ ! First F_Lic. No. lb` q`3CIass FT
Contractor's Address
Contractor's E-mail Address
72.3.vtL4
-
City - �� --_., State
G>
Zip Telephone 69
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO. lJ 7 Z-2 7--0
OCCUPANCY -GROUP 1 L_0 ,
_ v SU , PLAN CHECK FEE $