HomeMy WebLinkAboutF2019-0228 - Permit Applicationuor s ee for Fire Permit ApplicationCity of Newport Beach -Building DivisionF�r719-U,2
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Please print 3 copies
Associated Building Permit # j>0 Fire Sprinkler F_ Fire Alarm F_ Fire Misc
1. Project Address (Not mailing address)
Floor Suite No
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Tenant Name
City [
# Units (—
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F7 4. Arch itect/Designer's Name
Last
2. Description of Work
Architect/Designees Address
Architect/Designer's E-mail Address
City
Use
Zip � Telephoner �-,
5. Engineer's Name Last
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Extg Sq Ft F
New/Added Sq Ft Total Sq Ft �',
Valuation$
Engineer's E-mail Address
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City r y isC
# Stories
' Ojl New Add (- Alter Demo
6. Contractor's Name Last lei "-A First 5 r`i ° Lic. No. y'`/&X5 Class ((s
Check Appropriate Box for Applicant/Notification
F7, 3. Owner's Name Last
First
Owner's Address
Owner's E-mail Address
City [
State �
Zip F Telephonel�
F7 4. Arch itect/Designer's Name
Last
First I Lic. No. --- -
Architect/Designees Address
Architect/Designer's E-mail Address
City
State F_',
Zip � Telephoner �-,
5. Engineer's Name Last
n/ (;��
First 1 1_),4 -i -IC Lic. No. �
Engineer's Address
Engineer's E-mail Address
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City r y isC
State �—
Zip al') Telephone '/1 i U' - £/ 3- 00 /
6. Contractor's Name Last lei "-A First 5 r`i ° Lic. No. y'`/&X5 Class ((s
Contractor's Address
Contractor's E-mail Address
OWE
City __)1v,i . °,Cl.
State �+
ZipJ(r'[tr Telephone'?/Li - 1(f'7-?�
OFFICE USE ONLY
PERMIT NO. ��il " l o0z,
TYPE OF CONSTRUCTION
PLAN CHECK NO. lo
OCCUPANCY- GROUP
PLAN CHECK FEE $