HomeMy WebLinkAboutF2018-0642 - Permit ApplicationEW Pp
Worksheet -for Fire Permit Application
City of Newport Beach -Building Division
Please prink 3 copies f;,
ci�Fon"
Associated Building Permit # r _ _ [; Fire Sprinlder V Fire Alarm [- Fire Misc
ect Address (Not mailing address)
Tenant Name
2. Description of Work
— - Px---, r5 ( 3 i*✓ems
Extg Sq Ft � I New/Added Sq Ft _ Total Sq Ft
[ flew [] Add ❑ Alter [] Demo
Check Appropriate Box for ApplicantlNotification
Suite No
1�t
# Units =
Use
Valuation $ % 3 J
# Stories
3. Owner's Name Last Lji- Fi_�--�� I q��irst
Owner's Address Owner's E-mail Address
City 1 State �/ Zip 11 Z"� Telephone
�`
4. Architect/Designer's Name Last First - _ _- I Lic. No.
ArchitectlDesigner's Address
City _ _ State
Architect/Designer's E-mail Address
Zip Telephone
5. Engineer's Name LastC-'. I First _ Z(G_ Lic. No.
Engineer's Address
City G'��� fij� '. -� State C 1
i
Engineer's E-mail Address
Zip J Telephone G� S 1 NIP
n6. Contractor's Name Last �(� r� ° .. 1r t Lic. No. C-. Class)— l
Contractor's Address
City State
OFFICE USE ONLY
TYPE OF CONSTRUCTION
Contractor's E-mail Address
Zip C-- Telephoned-�
PERMIT NO.
PLAN CHECK NO.
OCCUPANCY- GROUP
PLAN CHECK FEE $