HomeMy WebLinkAboutF2018-0325 - Permit ApplicationWorksheet for Fire Permit Application
Print Form hh City of Newport Beach - Building Division
Please print 3 copies V «� 037_s_
Associated Building Permit # ✓� % i H ire Sprinkler ❑ Fire Alarm
X570
3 y'
G</PoPNP
[� Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Ej
Tenant Name t�Uti i�L��,� jj S t - # Units
J
2. Description of Work
Zip F Telephone
4. Architect/Designer's Name Last First Lic. No.
N6vJ �Nw-n& ('c S/�✓�,Niti�z S f
Architect/Designer's E-mail Address
Use
Zip Telephoned
❑ 5. Engineer's Name Last e,Z,41,A_J
Valuation $�'�. 4%
Engineer's
Extg Sq Ft F____1New/Added Sq Ft Total Sq Ft
–Address
� f�CGlIO'r"
1r�'VH*Cr,e-AW 010 �%avl//A i FavN—
# Stories
New F1 Add Alter ❑Demo
Check Appropriate Box for Applicant/Notification
n 3. Owner's Name Last First
Owner's Address
Owner's E-mail Address
City State F
Zip F Telephone
4. Architect/Designer's Name Last First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City I State
Zip Telephoned
❑ 5. Engineer's Name Last e,Z,41,A_J
First z„ Lic. No.
Engineer's
Engineer's E-mail Address
–Address
� f�CGlIO'r"
1r�'VH*Cr,e-AW 010 �%avl//A i FavN—
City p,�,,,(y State
Zip [7� Telephone
❑ 6. Contractor's Name Last 771
First � Lic. No. Class (�
Contractor's Address
Contractor's E-mail Address
)l- 'TI�ESFUS (%�v�
�jra✓�i�r�v,t�viP/dt2d���i�l , c„ --
City I rrUAT r A State
Zip �jrZIC,�G Telephone .�-/�'j'0 „ 5'F(�
OFFICE USE ONLY
PERMIT NO. �� W I ) 02; Z -
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $
,PWI7_ol08
S