HomeMy WebLinkAboutF2018-0339 - Permit ApplicationPlease print 3 copies
Associated Building Permit #
T—Ulg - oa22q
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Fire Sprinkler ❑ Fire Alarm ❑ Fire Misc
1. Project Address (Not mailing address) Floor Suite No
GiiVE?, F7
Tenant Name rwt, �rn.l�#.5 0� . 5�/_7
2. Description of Work
Use
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Extg Sq Ft New/Added Sq Ft !� Total Sq Ft
Valuation $ l.t v oo g
-
New ❑Add ❑Alter ❑Demo
# Stories C
Check Appropriate Box for Applicant/Notification
I n4nrro�4i�r
❑ 3. Owner's Name Last\/V 111c� S
First �qS�
Owner's Address
Owner's E-mail Address
32S C'7t�teYSar�J �r _
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City V't'L.wnCiG� State C
Zip I(� 5 Telephone fp iciz
❑ 4. Architect/Designer's Name Last—�
First E777771Lic No. �—
Architect/Designer's Address
Architect/Designer's E-mail Address
City State
Zip E-771 Telephone
❑ 5. Engineer's Name Last N i N
First Sa 61-47 Lic. No.
Engineer's Address
Engineer's E-mail Address
te3o-7 M-�,
-f-( UnCke4-V.-rc��r
City G`fey-LSS _ State
Zip �f� c' Telephone `tl:� G
❑ 6. Contractor's Name Last W i l k �
First ( Lic. No. i az,I`t os Class T
Contractor's Address
Contractor's E-mail Address
-:?LS <2,AVYSQt J SC"
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City State
Zip Gj1_1b+ Telephone
OFFICE USE ONLY ` PERMIT NO.� �7j3
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TYPE OF CONS -Lo
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $
97�1(, -- C) -Z,7
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