HomeMy WebLinkAboutF2020-0295 - Permit ApplicationWorksheet for Fire Permit Application 9726City of Newpo t Beach -Building Division Vq�j
Please print 3 copies �/
Associated Building Permit # IJ<Fire Sprinkler r Fire Alarm (` Fire Misc
1. Project Address (Not mailing address) Floor Suite No
%_('( West /(/h Uel r.3(vC?1/1 F F_
Tenant Name __-�. �' .:-(�'2 v�._. 1'� � S f G�_-E...,C..e # Units F
A P p^i-
2. Description of Work
Owner's E-mail Address
l/ 37
Use
Extg Sq Ft r— New/Added Sq Ft Total Sq Ft
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Valuation $ L v
_
y/
New r Add J_ Alter f7, Demo
# Stories
Check Appropriate Box for Applicant/Notification
3. Owner's Name 1 L � �V, IV LA4 j e �
V
First ��
Owner's Address
Owner's E-mail Address
�/ / 7
k.V
city JLC � f,r f.�A, State F
Zip — Telephone s-
r 4. Architect/Designer's Name Last
First F _ Lic. No. F
Architect/Designer's Address
Architect/Designer's E-mail Address
City _., State F
Zip r_ Telephonel--'---�--v�v
5. Engineer's Name Last
First Lic. No. F—
Engineer's Address
Engineer's E-mail Address
City _ State F_
Zip (— Telephoned----
6. Contractor's Name Last G rAOl S O
First Q Lic. No. L} 25` ,j2Class
Contractor's Address ��'rr2'��%1'� /RVk&4—irO` Con ail Address
14"t 5C) l _c, A� j Ave,.J'id
itracttorr''sE-m
C._t 'F�t lrcC r' c P�� lrct1�, Cu r,L
City C,- `�'.�--� State
Zipp( (%/p.,,. Telephone 'J �� 71 g' 7-5 G�
OFFICE USE ONLY „J PERMIT NO. UIV • 0 2015
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TYPE OF CONSTRUCTION
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W PLAN CHECK NO.
OCCUPANCY - GROUP
) PLAN CHECK FEE $