HomeMy WebLinkAboutF2018-0292 - Permit Application117-2GI8 *01021Worksheet for Fire Permit Application F2i,g_0;�City of Newport Beach - Building Division Please print 3 copies
Associated Building Permit #I ��o 17 3 vJ I Fire Sprinkler F7,Fire Alarm [7 Fire Misc
1. Project Address (Not mailing address) Floor Suite No
F
#Units
Tenant Name
2 Description of Work
Use
City �I ,��.�.. �9&kl„,State cp&6: 1 Zip
F777 Telephoned—
4. Archite i ner's Name Last�� 'First Lic. NO g te:2Yr'�'e Z First n, I E (47
Exiu Sq Ft New/Added Sq Ft �'�. Total Sq Ft F—
Valuation $
-- ---
City F_— State 77—_ Zip
# Stories
(^'i New r Add F_. Alter (7•••, Demo
First— Lic. No.
Check Appropriate Box for Applicant/Notification
3. Owner's Name Last First F
Owner's Address
Owner's E-mail Address
r
City �I ,��.�.. �9&kl„,State cp&6: 1 Zip
F777 Telephoned—
4. Archite i ner's Name Last�� 'First Lic. NO g te:2Yr'�'e Z First n, I E (47
Architect/Designer's Address
Architect/Designers E-mail Address G�
City F_— State 77—_ Zip
F Telephoned
5. Engineer's Name Last
First— Lic. No.
Engineer's Address
Engineer's E-mail Address
City State F Zip
—
Telephone
[`•••••• 6. Contractor's Name Last
First F_ Lic. No. F— Class—:
Contractor's Address
Contractor's E-mail Address
- �--�_�o_ TL%S biL %� � ._ _ l�
1, i�uv l0 l V;5, `�- -c--0
_
city) (�/C.,I..S..Q,�/S _ State �r Zip.l
�f�
��G
�7-tiA-(o
/ilSJ�a Telephone —_7Z_c ....1..25i_zz-?_
OFFICE USE ONLY
PERMIT NO. Z�I 0Z�
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP' _
( PLAN CHECK FEE $