HomeMy WebLinkAboutF2019-0413 - Permit ApplicationWorksheet for Fire Permit Application /579_20/q ��`"°RB
City of Newport Beach - Building Division F20/9 - 0413
Please print 3 copies G<;FoaN�P
Associated Building Permit # I Fire Sprinkler rj Fire Alarm j–I Fire Misc
1. Project Address (Not mailing address)
Floor Suite No
st Lcc
Owner's Address
Tenant Name
- -
# Units
2. Description of Work
City
Use
Zip F— Telephoned
g Sy Ft
i New/Added Sci 4 Ft Total S Ft
i i
Valuation $ if cri
-
r7New r—,Add
r— Alter r— Demo
#Stories
Check Appropriate Box for Applicant/Notification
(!_ 3. Owner's Name Laso OVA
st Lcc
Owner's Address
Own s E-mail Address -
•
City
State
Zip F— Telephoned
4. Architect/Designer's Name Last
1 First Lic. No.l
Architect/Designer's Address
Architect/Designer's E-mail Address
City
-
State _
Zip Telephone
F7 5. Engineer's Name Last �—
First Lic No. FI
Engineer's Address
Engineer's E-mail Address
City I—
State
Zip F---1 Telephone -
F_116. Contractor's Name Last s
First; Lic No. c_9 Class 6'
Contractor's Address
Contractor's E-mail Address
a7�G S� L
2 i"z
rre S nc
CItY S� o
State—
Zip Q Telone�
OFFICE USE ONLY PERMIT NO.
TYPE OF CONSTRUCTION
K ` C/ �U
PLAN CHECK NO.
OCCUPANCY- GROUP
40 % PLAN CHECK FEE $