HomeMy WebLinkAboutF2018-0146 - Permit Applicationol OG
Worksheet for Fire Permit Application o�rEW�
City of Newport Beach - Building Division o a
Please print 3 copies"`°""
Associated Building Permit #7hl C Fire Sprinkler r Fire Alarm r: Fire Misc
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1. Project Address (Not mailing address) Floor Suite No
# Units
Tenant Name
2. Description of Work
Use
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Valuation $
Extg Sq Ft New/Added Sq Ft F7777 Total Sq Ft
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01 - I Vi-CLl �A_C44iS
#Stories
Vk New f— Add (— Alter F_ Dema
Check Appropriate Box for Applicant/Notification
939091=1013 -
JZ._3. owner's Name Last (2_e,3 d-(�nC�lst
Owner's Address Owner's E-mail Address
City Po"/t_oref--"qg? State ZipF7777 Telephone)
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4. Architect/Designer's Name Last First Lic. No. 2
Architect/Designees Address Architect/Designer's E-mail Address
City _ C�,-f j O jq,�,:n/d i> State �.. Zip G%�7 Telephon '��
F- 5. Engineer's Name Last First Lic No.--'
Engineer's Address Engineer's E-mail Address
City State F_ Zip F7777 Telephoned
6. Contractor's Name Last ��� ��� First— Lic No.tClass C-�(�
Contractor's Address Contractor's E-mail Address
CityState �' Zip -I L,W-7 � Telephone ILI 2-4 / x 3
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OFFICE USE ONLY PERMIT NO.� L CJ V
TYPE OF CONSTRUCTION PLAN CHECK NO. OS7 I K: 1�)
OCCUPANCY -GROUP �� PLAN CHECK FEE $