HomeMy WebLinkAboutF2019-0346 - Permit ApplicationWorksheet for Fire Permit Application"`w'°"a
City of Newport Beach - Building Division /3i?S 20/ q{
Please print 3 copies F20 / 9 - C) 3N6 G<;�on�'�
Associated Building Permit # r n Fire Sprinkler F7, Fire Alarm j Fire Misc
1. Project Address (Not mailing address) Floor Suite No
J d
1 _._ _._ _. _... F
Tenant Name 4- �. „(ee #Units
aC=er r e ✓r
2. Description of Work
City �--
.. j State �—�I Zip F— Telephone[—
Use r_
Architect/Designers Address
pp� c
/Lc[o6.'14A� Z 6 F"Pe / ��!✓�...... _
City I—
_. _. _�
Extg Sq Ft New/Added Sq Ft �1 Total Sq Ft ��
�i I I I
Valuation $ Z
New I` Add F_ Alter F' Demo
# Stories
Check Appropriate Box for Applicant/Notification
3. Owner's Name
Last First F
Owner's Address
Owner's E-mail Address
City �--
.. j State �—�I Zip F— Telephone[—
F_ 4. Arch itecDesigner's Name Last 'First F Lic. No.
d�
Architect/Designers Address
Architect/Designer's E-mail Address
City I—
�... State Zip ' Telephoned.
F 5. Engineer's Name
Last r�-- First F——_ Lic. No.
Engineer
Engineer's E-mail Address
City
StateI Zip Telephone
F 6. Contractor's Name Last
V � F SfSk�rs First F--Lic, No. 5? 2_3? Class
Contractor's Address
Contractor's E-mail Address
(�AAVe )< F,'Pt Sl'S �O
City �—
.State Llok Zip %ZfN�j ',, Telephone.. _.
OFFICE USE ONLY
PERMIT NO. — 0
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $
1c ao� -0