HomeMy WebLinkAboutF2018-0286 - Permit ApplicationWorksheet for Fire Permit Application 115-7-2p18
City of Newport Beach - Building Division V7018- 0280 o .
Please print 3 copies
Associated Building Permit # Fire Sprinkler, Fire Alarm ire Misc
1. Project Address (Not mailing address)
ecoctr, -A
Floor
Fw
Suite No
"'f}
33021 3. S- SIA- W00, N66vFORT _C
Tenant Name Lose- E•bh�5
#Units
/U
2. Description of Work
Use
�KIbFF?E
Extg Sq Ft �! New/Added Sq FtF Total Sq Ft F
Valuation $
/
#Stories
F7
F', New ri Add j- Alter F_ Demo
'
Check Appropriate Box for Applicant/Notification
Information
rVI 7" 3. Owner's Name Last 1i C7 Fust- l VA -Al
Owner's Address Owners E-mail Address
'��24F Pe. I ++ZCO
City I $R11 IN C- State G.�-- Zip G{2!o t' Telephone
- - 9' -
[' 4. Architect/Designer's Name Last �— First Lic. No.
Architect/Designers Address Architect/Designers E-mail Address
City � State F— Zip F Telephoned_
j,25'J5. Engineer's Name Last 0KP09D First NtAT? Lis No.
Engineers Address Engineer's E-mail Address
6 09CRAj 1'3 t115' 200 1 MOX4<>14 @CVc -inc. ftzl"_
City /,r9'KE 'Q ST -_, State Zip 926 _ Telephone q4q- 716 - 3940
1 6.'Contractor'sName Last LANIDSEA 1+OLDuUCai % Firstl Lic. No. i06g0� Class
__ CoRFt�KN?tom _
Contractor's Address Contractor's E-mail Address
-JSUiN k.G� � )5he. ZX7 e-6�1-�.L64"� -V%jO
City ,r;r State C/}" Zip 9 26 ( & Telephone R 4M - 9j1.S- 80�0
\OFFICE USE ONLY PERMIT NO.
B 1�
yPF OF CnNSTRIICTION PLAN CHECK NO.
GROUP PLAN CHECK FEE $2 cu