HomeMy WebLinkAboutF2019-0612 - Permit ApplicationPlease print 3 copies
Associated Building Permit#
Worksheet for Fire Permit Application o�"EwRm
City of NeVport Beach - Building Division
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1 17 Fire Sprinkler Fire Alarm [—j Fire Misc
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1. Project Address (Not mailing address) Floor Suite No
Owner's Address
Tenant Name C�,�.P� #Units
2. Description of Work
City State F
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EMg Sq Ft �(�, G U Naw/Added Sq Ft F � Total Sq Ft Z � C�✓
Valuation $ `3 l9cj
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414—
FI New Add r Alter Demo
# Stories
Old
Check Appropriate Box for Applicant/Notification
I nfn rm #inn
F, 3. Owner's Name Last IFirst— '
Owner's Address
Owner's E-mail Address
City State F
Zip -- Telephone s
4. Architect/Desi 9 ner's Name
Last 1 First / Lic. No.
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Architect/Designer's Address
Architect/Designer's E-mail Address
CO %1Z-i-4cG FItu, LLS) m.v,. Ga r�
City I-Vi✓k-; Jv.v ���/�
State FEa
Zip [uy7 i Telephone r-jZ'�.�70 7?7 _G
['i 6. Engineer's Name Last
. Lic. No. F
First F_
Engineer's Address
Engineer's E-mail Address
City _ _
State �_—,
Zip ---'_u! Telephone—
6. Contractor's Name Last ph._j L i
First Lic. No. '7'Z /j Class LJ (%
Contractor's Address
Contractor's E-mail Address -
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City
State Cyd ..
Zip .._._ Telephone 7& jio T7J-U
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $