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HomeMy WebLinkAboutF2018-0628 - Permit ApplicationWorksheet for Fire Permit Application o�� City of Newport Beach - Building Division o Please print 3 copies 24 rl ICA I D s Ova `°`�,P Associated Building Permit# 'WI'), 3Uz X Fire Sprinkler f7, Fire Alarm Fire Misc ' ___ _ _._u._-. _._ - 1. Project Address (Not mailing address) Floor Suite No S_��_ QZL I% iV2 r� #Units 1 Tenant Name - 2. Description of Work Use --- �ri'e S�✓rV� �zr S _fay _SFR 2� tie�c�S, Itvldi F- 4. Architect/Designer's Name LastTo, P First Fjco Lic. No. Valuation $ Extg Sq Ft New/Added Sq Ft Total Sq Ft �—'. V4 #Stories (- New [-;: Add )!:. Alter Demo U✓ 6se, 0l Check Appropriate Box for Applicant/Notification 3. Owner's Name Last tj011 i�ayD�'Q/'lVG UG First F Owner's Address Owners E-mail Address City i State Zip Telephone F- 4. Architect/Designer's Name LastTo, P First Fjco Lic. No. F— Architect/hDe��signers Address Architect/Dpe�signer's E-mail Address U gr�. cdo I/2✓L4rdS'Swl V4 State /� �7I City _SY (,pV('✓l4' i.l�.`.�-_... Zip Telephon�e/,�/i��J�%%".���7 �, 5. Engineer's Name Last First— Lic. No. F Engineer's Address Engineer's E-mail Address City State Zip F Telephoned-- ----------- F-6. Contractor's Name Last r��nv�V�i S(7Yi� p( QY First F—' Lic. No. rg7Q Class F1 J I, Contractor's Address Contractor's E-mail Address l� �ldf SSS ,Corgi q.3_rcO/vrG _A✓_ - JGIMgI City 1. g V .. .. State CA Zip. J© .. Telephone 1[71 Y' USE ONLY OF CONSTRUCTION - GROUP PERMIT NO. F? l i • UK* PLAN CHECK NO. "a4o[D Y ht 5 0:. -i. PLAN CHECK FEE $