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HomeMy WebLinkAboutX2016-2183 - Permit Application (2)Print Form Please print 3 copies 0 Associated Building Permit Worksheet for Fire Permit Application�O�+���o� R� City of Newport Beach - Building Division C,IFORR' [_ Fire Sprinkler i_ Fire Alarm r Fire Misc 1. Project Address (Not mailing address) Floor Suite No 1 #Units I Tenant Name ® aS ` �® �1u � Y\J � o n 'e 2. Description of Work ` o `( \A00 ' ` �,} — ' G ' CAV�ce S Use U yt C, ef- ©© Valuation $ 1506 Extg Sq Ft F New/Added Sq Ft Total Sq Ft # Stories New r Add j_ Alter Demo �h"ALC Check Appropriate Box for Applicant/Notification F_ 3. Owner's Name Last _ _ First F Owner's Address Owner's E-mail Address City F State F Zip �� Telephone�� F_ 4. Arch itectlDesigner's Name Last F First F Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address City State F_Zip [_ Telephone[— F_ 5. Engineer's Name Last F First Lic. No. Engineer's Address Engineer's E-mail Address City F State F_ Zip F_ Telephone F_6. Contractor's Name Last F [ S . 1 First F Lic. No. 11 q 13 Class r Contractor's Address Contractor's E-mail Address 1e .0 V�o �, � "�-�i a ��s &\T V-v>lle-sy s vv\\ ., CD M City G 1&-Cr rn�r� ttr'� a State �i Zip 5 Telephone�� �- 2 j (` 94­1 (t)o PERMIT NO. 1'u 11( ^- 03W. OFFICE USE ONLY TYPE OF CONSTRUCTION PLAN CHECK NO. OCCUPANCY- GROUP PLAN CHECK FEE $