HomeMy WebLinkAboutF2018-0147 - Permit Application (2)O<_-7�77L-( -7-01b
Print Form
Please print 3 copies
Associated Building Permit #
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Worksheet for Fire Permit Application �6WPO T
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City of Newport Beach - Building Division g
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Cy<I[O PNEP
Fire Sprinkler F Fire Alarm F Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Tenant Name (� B G OG i� — # Units I
L
2. Description of Work
IlVeco
Use
Extg Sq Ft �— New/Added Sq �
Ft F7--7Total Sq Ft
Valuation $
F77-7
F7
n New FJ Add n Alter [� Demo
#Stories
Check Appropriate Box for Applicant/Notification
F 3. Owner's Name Last First
Owner's Address Owner's E-mail Address
/7;46o Sc 47, ,vce, �%e fi
City � 0 r 4 — State Zip r ------ 7
Telephone
4. Architect/Designer's Name LastJ First F—_ J Lic. No.
---- - -
Architect/Designer's Address Architect/Designer's E-mail Address
City - l State F7777 Zip Telephone
F 5. Engineer's Name Last First F---- Lic. No. l
Engineer's Address Engineer's E-mail Address J
City State F—Zip �— Telephone
6. Contractor's Name L t _ ( LT7a? lFirst L�/-C- — Lic. No. , ClassF
I
�—'R� X30 43
Contractor3 - --
s- dress Contractor's E-mail Address
City 76 v -_ --. State Zip 2�t7 J Telephone Zy : �� 1/ _
OFFICE USE ONLY PERMIT NO.
TYPE OF CONSTRUCTION PLAN CHECK NO.
OCCUPANCY- GROUP PLAN CHECK FEE $