HomeMy WebLinkAboutF2018-0634 - Permit Application.2111 -Ail
Worksheet for Fire Permit Application �fdtg. )f; yq
City of Newport Beach - Building Division �
Please print 3 copies 't 1 Arede Ave
Associated Building Permit #- Fire Sprinkler F7, Fire Alarm [`•••. Fire Misc
1. Project Address (Not mailing address)
Floor Suite No
Tenant Name
O 1,`J J.
#Units
III
2. Description of Work
Use
EMg Sq Ft F_New/Added
Sq Ft ���. Total Sq Ft ��.
Valuation $ Q-
-
# Stories l �--'
F7 New
[` Add F After F_ Demo
Check Appropriate Box for Applicant/Notification
I! 3. Owner's Name Last First
Owner's Address Owner's E-mail Address
City -... State Zip Telephoned—
[ 4. Arch itect/Designer's Name Last First F Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State Zip Telephone
F 5. Engineer's Name Last First' Lic. No. F_
Engineer's Address Engineer's E-mail Address
city State F_ Zip F— Telephoned-
F_ 6. Contractor's Name Last 'l�IFirstLF-Ar Lic No.'b� 1� � Class F0
Contractor's Address ` VV �V Contractor's E-mail Address
X94-4
City (S�� State TA—zip �'�2 TelephoneiOltjOtr-�'�.�.,rJ2F,'�1
OFFICE USE ONLY J PERMIT NO. I DW QOW
TYPE OF CONSTRUCTION PLAN CHECK NO. M1'2-006
OCCUPANCY- GROUP PLAN CHECK FEE $
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