HomeMy WebLinkAboutF2019-0447 - Permit ApplicationPrint Form
Please paint 3 copies
Associated Building Permit #
Worksheet for Fire Pennit Application P
City of Newport Beach - Building Division 8756 -.?0l9
F201? -007 �,�ro�,;.
1' X FireSprinader F- Fre Alarm F- Fire Misc
9. Project Address (Not mailing address) Floor Suite No
(L�'i(..
#Units
Tenant Namell
2. Description of Work
City State �
Jel J r
Use
{ o
J n 3
s E mai Address
Eztg Sq Ft New/Added 39 FT � Tota9 Sq
II Ft
Valuation$ 17%,����
aty F— state
#Stories j
F- New F Add F Aker F Demo
Fest— UG No.
Check Appropriate Box for ApplicanWolifiication
F 3.Owner's Name Last
Fest
Owns Address
Owners E-mail Address
City State �
2rp F— Te'fephoneF— �I
F- 4. ArchitacNDesignees Name Last 5 mm � Fest �; Uc No. �Y
"�
Architect/Designees Address
s E mai Address
aty F— state
zipF—T6epbmeF—
IF 5. Engineer's Name Last
Fest— UG No.
Engineers Address
11
Engineer's E-rrrall Address
—11
Oily State.I'
Zipli Tetephar�--
PC6. Corrtracfor"s Name LasaL'.Mrt7 Fest EP-„r� Lic No.
Contractors Address
Conba"s -mall Address
Ps0/%// %n=-�Ki>ti %f c'e',
9" (
}}E
G;.$c.�.'y (6” -1i'l'ne"G-�tc�j�-�5'�e.
City state
Zip T/elePhone (fiiJ'%i�i✓E3
OFFICE USE ONLY
PERMIT NO. Flo t `• bu41
TYPE OF CONSTRUCTION
PLAN CHECK NO_
nr:r.LLPANPY - Mnl IP
. ... 11 e
I&i-Pub
XIA11 -I [oil