HomeMy WebLinkAboutF2019-0010 - Permit Application (2)Worksheet for Fire Permit Application (3)
City of Newport Beach - Building Division � %1 C A V veV 3
Please print 3 copies t U I $ , 0 ( (�)
Associated BuildingPermit # �F' Fire S'� L
Sprinkler � Fire Alam r Fire Misc
1. Project Address (Not mailing address)
Floor Suite No
SY03___=SeaE a_te
—
Owner's Address
Owner's E-mail Address
# Units
Tenant Name
_.._ State F Zip
F Telephoned—'.
2. Description of Work
F- 4. Architect/Designer's Name Last V0 First Jd Lic. No.
F
Use
Li .� (rrr (� i
�i'Yly EPro-kle✓S or JFR (_21 he JS)
Architect/Designees E-mail Address
Valuation$
Extg Sq Ft F_'
New/Added Sq Ft F_, Total Sq Ft
C4 W i CaV1,..VteI
__ '... State 1 .... Zip
# Stories 57
(^ New [_., Add
F_Alter F_Demo
Last
Check Appropriate Box for Applicant/Notification
F- 3. Owner's Name
Last
:First F
Owner's Address
Owner's E-mail Address
City �—
_.._ State F Zip
F Telephoned—'.
F- 4. Architect/Designer's Name Last V0 First Jd Lic. No.
F
Architect/Designees Address
Architect/Designees E-mail Address
5z6th/_N 5.66 dq
_�I � - -
;re v9q'5,y p y%rtIII Cvm
C4 W i CaV1,..VteI
__ '... State 1 .... Zip
6�4 t l k. Telephone (71'7) 31�'Ql
r 5. Engineer's Name
Last
First
Engineer's Address
Engineer's E-mail Address
City
State F777 Zip
F Telephone--
I— 6. Contractor's Name
Last r, re,nvo SPy,,,� k l Q y
J I`
First �� Lic No. yIO 2 Class
/6
Contractor's Address
Contractor's E-mail Address
d c f/orl_�t �1 Q __
,, l e �vw c S's � whar 1, Caste
City ; S_uA 6q le
_. _..... State 104 Zip
I U2 Telephonel(71q) 310_NgV
OFFICE USE ONLY PERMIT NO. )14 t C01�
PLAN CHECK NO.
TYPE OF CONSTRUCTION
OCCUPANCY - GROUP
PLAN CHECK FEE $