HomeMy WebLinkAboutF2019-0538 - Permit Application3lease print 3 copies
Associated Building Permit #
I. Project Address
Tenant Name
Worksheet for Fire Permit Application
City of Newport Beach - Building Division g�"
Fire Sprinkler %`�
fiY', Fire Alarm [ Fire Misc
add
2. Description of Work
Extg Sq Ft New/Added Sq Ft �—J
Total So Ft s-
0 New
E] Add ❑ Alter ❑ Demo
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# Units
suite No
s_I
sl
Use
r !Y
' valuation $Ej Z�
C
# Stories 1
Check Appropriate Box for Appiicant/Notification
. ����—I
[� 3. Owner's Name .Last rst
Owner's E-mail Address
Owner's Address J
I h%�l441
Zip -L4-�� ._ Telephone
City ill— I {% State L V�[ �—
E]4. Architect/Designer's Name Last
Architect/Designer's Address
—�
City State
First
Last __ _
First
Lic. No.
— - I
Architect/Designer', E-mail Address
Zip Telephone
-
E] 5, Engineer's Name
Engineer's Address -
stateC"
city �'�d "----
dit�-1
Last
Engineers E-mail Address
Zip t—N--I I—] Telephone G �
Lic. No.=
D6. Contractor's Name
Contractors Address
—� State
City -- -----_
OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY- GROUP
Lic. No.—j Class—I
Contractors t -man Huu, cam=
Zip
I Telephones
t� iorv� i i`` ✓'sy
PERMIT NO. -
PLANCHECKNO.
PLAN CHECK FEE $ F"—