HomeMy WebLinkAboutF2019-0312 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # �— Fire Sprinkler [-I Fire Alarm (71, Fire Misc
1. Project Address (Not mailing address) Floor Suite No
2121_Sey4fAVS i F-7711
Tenant Name -, _.. ----. -.. --,-_ - I # Units I
I
2. Description of Work
Use
I iiPi7Vlil`i�[rS lob ��.� f(QQ�SJ
Extg Sq Ft I ' New/Added Sq Ft �� Total Sq Ft I I
Valuation $-711000 1
n New F_ Add r— Alter F— Demo
71
# Stories I /71
Check Appropriate Box for Applicant/Notification
3. Owner's Name
Last ��ItlQ.i First[
Owner's Address
Owner's E-mail Address
City e -. C �y Zip -- Telephoned—,
� +�
4. Architect/Designer's Name
Last v1 0 First Jd Lic. No F
Architect/Designer's Address
Architect/Designer's E-mail Address
ilk �q� SS ��ltita�°z!. Coil
City W�/cI co vfKq
�—
--. State r� n Zip ! U ��,,,,, Telephone % f (l�V �/ f
1 �,lFirst 6
5. Engineer' Name
Laic No. (---'
Last �—
Engineer's Address
Engineer's E-mail Address
City
StateZi p—i Telephone— ---_
[16. Contractor's Name Last6 F'e..�First I Lic. No. ���� 22 Class f
66 1b
Contractor's Address
SYS __V r_'c fot�c'a Ade _
Co tractor's E-mail Address
rf��rra 5'5- & p*qf 7 Cori,
City SIS �f �t Pe
State V4 Zip 102 Telephone U/ Z)7!` _ a t y
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OFFICE USE ONLY
TYPE OF CONSTRUCTION
PERMIT NO. r Wdiq .0512.
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J PLAN CHECK NO t b
OCCUPANCY -GROUP
, 0 ril PLAN CHECK FEE $