HomeMy WebLinkAboutF2019-0460 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division 181? ;Zt7�9
Fwjt?-0160
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mailing
Vit,
Name WY
2. Description of Work
Fire Sprinkler rjFire Alarm F-, Fire Misc
Floor
F77
# Units
j''S�ui't'e NNo'-;
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iyf. C.?Y-m -TT MOWS —_J I Use
Extg Sq Fti— -- _ New/Added Sq Ft r----.---.—. Total Sq Ft F77777
New Add FX Alter ❑Demo
Check Appropriate Box for Applicant/Notification
r 3. Owner's Name Last First
Owner's Address Owner's E-mail Address
Valuation
$ FZSo•__—I
# Stories
City—_.__...—_-. --
State r--._---' Zip ^-_-------.. Telephoned.-_.--..__.--_
F7, 4. Architect/Designer's Name Last i
_ First r — — ` —, Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
- - - ---
City State F.-.--_. Zip I_ ---.-_.i Telephone ---.---__-_
(`I 5. Engineer's Name LastI First F — - -- -I
_ - -i - I Lic No. �
Engineer's Address
Engineer's E-mail Address j
#I
City F--------7State I- Zip �---.---�� Telephone
6.
Cnt Contractor's Name Last �__ Y First Lic.
E-mail Address
Lic. No. 05 �48 Class
' -Jec4 a0l ON , D_U
Contractor'sAddress
I 7 Vf YUtGC
1 Q' \N - ba i. ss
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City of Q - I State CA ZIP - `/i��Q J Telephoner-1 T'�D"J? (J�
OFFICE USE ONLY bul 1l Q W L PERMIT NO. tak • 0,440 O
TYPE OF CONSTRUCTION _ ^U "j jar Zw� PLAN CHECK NO. ( r l
OCCUPANCY - GROUP M 1 ` t \ PLAN CHECK FEE $