HomeMy WebLinkAboutF2018-0534 - Permit Application'�r�. D� }
Worksheet for Fire Permit Application o4zEW�Qa
Print Form
City of Newport Beach -�B�il"ding Division a
Please print 3 copiesJCI/p`'I • C�% Ijlti'l�°^""
Associated Building Permit # /K Fire Sprinkler ❑ Fire Alarm ❑ Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Tenant Name CN�(c.,C #Units
JJJ
2. Description of Work
Use
Owner's E-mail Address
City .__
State Zip
F__7 Telephone
4. Architect/Designer's Name
Last
valuation $3'7jt ,-v)
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Extg Sq Ft J New/Added Sq Ft �J Total Sq Ft
Architect/Designer's E-mail Address
City
# Stories
57
New r7 Add ❑Alter [7 Demo
Check Appropriate Box for Applicant/Notification
3. Owner's Name Last
First
Owner's Address
Owner's E-mail Address
City .__
State Zip
F__7 Telephone
4. Architect/Designer's Name
Last
First Lic. No.
—71
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State Zip
Telephoned
_ 5. Engineer's Name Last
First F Lic. No.
'Engineer's Address
Engineer's E-mail Address
City _ _
State F7 Zip
Telephoned
6. Contractor's Name Last r" ar S ®
First Lic. No. 3u Class Ll(p
Contra/cttor's Addreessy�
Contractor's E-mail Address
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4orS�i (' _
City S"/kvr��q-r,�/ ( �'/W
State Zip
�(,.�'"� Tele .o{e
OFFICE USE ONLY
PERMIT NO.
2�1)
TYPE OF CONSTRUCTION
PLAN CHECK NO.T
OCCUPANCY- GROUP
PLAN CHECK FEE $