HomeMy WebLinkAboutF2018-0569 - Permit Application3 copies
Building Permit #
1. Project Address (Not
Worksheet for Fire Permit Application
City of�lewport Beach -Building Division
address)
Tenant Name ---
2. Description of Work
Fire Sprinkler ❑Fire Alarm [ Fire Misc
rlr� Sok, rs idr relmoJet ldd',4/Ori '5L 4 S
Extg Sq Ft F7__7New/Added Sq Ft F Total Sq Ft
New E] Add Alter Demo
Check Appropriate Box for Applicant/Notification
H Use
❑ 3. Owner's Name Last First
Owner's Address Owner's E-mail Address
City State Zip L Telephone[
❑ 4. Architect/Designer's Name
Last rVT_ First
Architect/Designer's Address d ���JJJ
MC V S;ha �c a e A,19
,
City i��p�,]. �_,,�a— State FA -7
Floor
F7
# Units I
Valuation $
# Stories
Lic. No.
Architect/Designer's E-mail Address
SP -610- I
ZIP 7 d Telephonne (T(y) o _Q[9 -
C
1
Suite No
❑ 5. Engineer's Name Last 77 First
Lic. No.
Engineer's Address Engineer's E-mail Address
City r- State ZIP F __7 Telephoned
❑ 6. Contractor's Name Last F777771'Z('C
first Lic. No. � Class
Contractor's Address Contractor's E-mail Address
City lJq'1'2 State ZIP Telephone z/�� fc�
OFFICE USE ONLY o u 1 PERMIT NO. 'I' LL
TYPE OF CONSTRUCTION _ i '/ t PLAN CHECK NO.
OCCUPANCY -GROUP i1�� / 11 0-/A
PLAN CHECK FEE $