HomeMy WebLinkAboutF2019-0620 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
1. Project Address (Not mailing
OQO 3irGh
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
r Fire Sprinkler r Fire Alarm Fire Misc
Tenant Name I i Oj `_
2. Description of Work LVs
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Extg Sq Ft New/Added Sq Ft F ToSqFt F
r New r Add r1 Alter r Demo
UnecK Appropriate tioz tor AppiIca nt/Notification
Floor Suite No
77
4900
# units t—
Use---
Valuation $ �J
# Stories
r 3. Owner's Name
Last 7 First
Owner's Address
Owner's E-mail Address
City
State I J Zip tI Telephoned
r 4. Architect/Designer's
Name Last First— Lic. No.f
Architect/Designees Address
Architect/Designer's E-mail Address
City
State L Zip Telephone
r 5. Engineer's Name
Last First Lic. No.
II��_J
Engineer's Address
Engineer's E-mail Address
City
-J State Ziptt Telephone[[
r 6. Contractor's Name
Last 4:;i r-exq fe /7 {Trr First �— Lic. No. ci 0 % i. Class \vr tC ,,,
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Contractor's Address
Contractor's E-mail Address
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L
City ,f p n L-0 A-4 q State (111 J Zip 9 of Telephon 171 J 1; - - �, w
OFFICE USE ONLY
�( C � ij / PERMIT NO. (J
i (k
TYPE OF CONSTRUCTION
/ ` I i PLAN CHECK NO. It
OCCUPANCY - GROUPS
A 2 I % PLAN CHECK FEE $ (✓ J t '
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