HomeMy WebLinkAboutF2019-0357 - Permit ApplicationPlease print 3 copi6
Associated Building Pe it 4
1. Project Address (Not i
Tenant Name
2. Description of Work
Worksheet for Fire Permit Application IHoq _Zj?
City of Newport Beach - Building Division F,�O Iq -033-7(9
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Extg Sq Ft New/Added Sq Ft Total Sq Ft
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PplupliclUt oux tor Appi i cant/ Notification
Floor Suite No
4 Units
Use
Valuation $ ,�00
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j 3. Owner's Name Last
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Owner's Address
Owner's E-mail Address
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City r—l
state zip Telephone
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r74.Architect/Designer's Name
Last F�; First F_ Lic. No, F_
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State F_ Zip_j TelephoneF___,
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15. Engineer's Name Last
17
First Lic. No.
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Engineer's Address
Engineer's E-mail Address
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City
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state Zip Telephone
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F -' First 6. Contractor's Name Last Lic. No. Class
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Contractor's Address
Contractor's E-mail Address
City
State ZIPF�t,-)-Ce_2 G-, Telephone 71-f - —9c)-> — 17
OFFICE USE
0DO& - zo LCI PERMIT NO.
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TYPE OF CONSTRUCTION=
PLAN CHECK
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OCCUPANCY
OCCUPANCY - GROUP
7 %
LAN CHECK FEE $