HomeMy WebLinkAboutF2020-0222 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division o
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Associated Building Permit # Fire Sprinkler Fire Alarm F Fire Misc
1. Project Address (Not mailing address)
Floor Suite No
`3_ -- - FU. L"Ase - --4- -
------ -_ron - _e f- 4 ---
' F F777
Tenant Name(----
j
# Units
-
-
State—. Zip ----I Telephone -
2. Description of Work
First-
_--- Lic. No.
Use FSF9
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Extg Sq Ft New/Added Sq Ft otal Sq
-_...-- -— -- —
Valuation
IT New j` Addr- Alter
Demo
#Stories
Check Appropriate Box for Applicant/Notification
IN�f�MM.f I'/1M
[i 3. Owner's Name Last � � First
Owner's Address
Owner's E-mail Address
City �— .. -!
State r Zip C--- Telephone
4. Architect/Designer's Name Last
First Lic. No.
Architect/Designees Address
Architect/Designer's E-mail Address
City
State—. Zip ----I Telephone -
[; 5. Engineer's Name Last
--
First-
_--- Lic. No.
Engineer's Address
Engineer's E-mail Address - - -
City....State
F—, Zip F___—. ;.....Telephone_
6. Contractor's Name Last_ First . Q�- alley Lic No. Class
Contractor's Address
Contractor's E-mail A dress
C 19
city �n a(o_ C,.) .-
State Zipf � Telephone ,'� 2/A,1�i�%v/
OFFICE USE ONLY
PERMIT NO. OZ,�ryO( O�(
TYPE OF CONSTRUCTION
PLAN CHECK NO. d V
OCCUPANCY - GROUP
ao I G I / PLAN CHECK FEE $
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