HomeMy WebLinkAboutF2019-0217 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
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Associated Building Permit 1 j j Fire Sprinkler F-1 Fire Alarm j -I Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Last �— First F
Tenant NameI 14',p i � �5'�CivJ ¢.. X' # Units I
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2. Description of Work
City
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Use
Extg Sq Ft I New/Added Sq Ft �� Total Sq Ft F�—�;
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Valuation $
F7 New F_ Add Alter F_ Demo
# Stories F
Check Appropriate Box for Applicant/Notification
. 3. Owner's Name
Last �— First F
Owner's Address
Owner's E-mail Address
City
i State Zip — Telephone
4. Architect/Designer's Name Last First Lic. No.I— —
e—
Architect/Designer's Address
, Architect/Designer's E-mail Address
City
State-- Zip I-- r -- Telephone[
(- 5. Engineer's Name
Last First—', Lic. No
Engineer's
Engineer's E-mail Address
city
State Zip r_--, Telephone[—�
6. Contractor's Name Last
7J/y First— -v— Lic No. 73396 Class
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Contractor's Address
Contract is E-mail Address
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City
State (- /i iA —� Zip^; Telephone rp�����
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OFFICE USE ONLY
PERMIT NO.
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TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
k t L):�—Z_9Lj PLAN CHECK FEE $