HomeMy WebLinkAboutF2018-0087 - Permit ApplicationTZOq - 0(x1
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
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Please print 3 copies
Fire Sprinkler Fire Alarm I`I Fire Misc
Associated Building Permit# F— -"
1. Project Address (Not mailing address)
Tenant Name _,P z-_7 LG.y,,3s,t
2. Description of Work
Extg Sq Ft F— New/Added Sq Ft F Total Sq Ft
{-1 New r Add Alter F- Demo
Check Appropriate Box for Applicant/Notification
Floor 5utte NO.
# Units I I
Use
Valuation $S 1�7_0071
# Stories F-7
[" 3. Owner's Name Last
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First
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Owner's E-mail Address
Owner's Address
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State
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Zip
9lol� Telephone
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City
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Lic.No.4�-�L�:
4. ArchitectlDesigner's Name
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Architect/Designer's E-mail Address
Architect/Designers Address
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State
CSR
Zip
`rlOrrP Telephone
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City
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Firs
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Lic.No.F
r 5. Engineer's Name Last
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Engineer's Address
Engineers E-mail Address
State—.... Zip �. Telephoned.
City
Dc e First— Lic. No. f�23 Class
E7 6. Contractor's Name Last --- -
Contractors Address Contractors E-mail Address
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City ,.�;r� _.-- State G� Zip ( ck 10f (0 Telephone Gzre
�((PERMIT NO. ' 0v� /
OFFICE USE ONLY O?� f2�
TYPE OF CONSTRUCTION iii . Q� f PLAN CHECK NO. _ 3�
PLAN CHECK FEE $
OCCUPANCY- GROUP