HomeMy WebLinkAboutF2019-0250 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application og3t;?Dl,�
City of Newport Beach - Building Division
fW /q- 0250
Fire Sprinkler r Fire Alarm r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Last �Ir n .-..
W�
Tenant Name # Units
2. Description of Work
1=ie-e, .S�2.�w1�Fe.rL -Sys4ea�
Use
w� 25 treti. hFr�e-�
Valuation $ LI
Extg Sq Ft F- New/Added Sq Ft F-' Total Sq Ft 1�',
r(XK .
New j_ Add r Alter ('Demo
# Stories
F
Architect/Designees Address
Check Appropriate Box for ApplicantlNotification
Ini�rro.�4inn
F_ 3. Owner's Name
Last �Ir n .-..
W�
First
Owner's Address
Owner's E-mail Address
City I
State ��
Zip � Telephone
F_ 4. Architect/Designer's
Name Last First I Lic. No.
F
Architect/Designees Address
Architect/Designer's E-mail Address
City
State
Zip Telephone
F_ 5. Engineer's Name
Last
First F Lic. No.',
Engineer's Address
Engineer's E-mail Address
City
State
Zip Telephone
6. Contractor's Name
Last', g3tlk,q First N1 rILC Lic. No. clSC. IIS Class', (-lb
Contractor's Address
Contractor's E-mail Address
Ila( Legs Flou.ir.S
i IpiIICAan I . cc?n-•
City I 41-Itso "WPJc>
State fl1
Zip I 6JIVS1c Telephone '-4")) ZZQ, 11-1
�'
OFFICE USE ONLY ` PERMIT NO.
TYPE OF CONSTRUCTION XIIA��Q s PLAN CHECK NO.
OCCUPANCY- GROUP
PLAN CHECK FEE $