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F2018-0431 - Permit Application
Worksheet for Fire Permit Application Print Form City of Newport Beach - Building Division Please print 3 copies Associated Building Permit #� 1. Project Address (Not mailing Tenant Name 2. Description of Work ii(f Fire Sprinkler ❑ Fire Alarm ❑ Fire Misc TIte spV't/Jkleri •for ��� 23 sprr/Idea) Extg Sq Ft New/Added Sq Ft �— Total Sq Ft L �J F J New r- Add F- Alter r Demo UnecK Appropriate tsox Tor Applicant/Notification I_x____ _A-_._ 4?6WvoRr o m u �<icoPN�" Floor Suite No F7 # Units 1 1 Use Valuation $ G(JQ S #Stories r 3. Owner's Name Last First �— Owner's Address Owner's E-mail Address City _J State Zip � TelephoneC F_ 4. Architect/Designer's Name Last First 0 vl Lic. No.� ArchitecUDesigner's Address Architect/Designer's E-mail Address `I ��lttci c t/e �1/r 5 0 -_ City S- %�._ _��� State Zip l7ge Telephone .6(g (' 5. Engineer's Name Last First �� Lic. No Engineer's Address Engineer's E-mail Address IIlI���� City State C� Zip F--77 Telephone (— 6. Contractor's Name Last First �� Lic. No. �q z Class© Contractor's Address -"'---•� Contractor's E-mail Address l vgvq SS��Fj CityS �f _ _ �- rq J l 7 State Zip G Telephoned OFFICE USE ONLY PERMIT NO.iiZAC17!! TYPE OF CONSTRUCTION PLAN CHECK NO. OCCUPANCY - GROUP --03 7 Z PLAN CHECK FEE $ 0-I-6t'7--'fit �