HomeMy WebLinkAboutF2019-0245 - Permit ApplicationPrint Form Worksheet for Fire Permit Application
City port Beach -Building Division II
Please print 3 copies F2_0I � . 02-4q
Associated Building Permit ` �FireSprinkler F -Fire Alarm F_ Fire Misc
U51
1. Project Address (Not mailing address) Floor Suite No
122 _Z5* _ S�✓ee � _ _ F_
Tenant Name # Units ....
2. Description of Work,.
Use 1
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fire S�YiI��•�'e✓s �� SFR �26 He�ds�
Extg Sq Ft New/Added Sq Ft F- Total Sq Ft I�'
valuation$ S�of0a
F_ New (_ Add r Alter (_ Demo
# Stories OL
C 4. Arch itectlDesigner's Name
Last vey First Jdf . k Lic. No.
Check Appropriate Box for Applicant/Notification
F_ 3. Owner's Name Last
First F_
Owner's Address
Owner's E-mail Address
city
State Zip Telephonel�l
C 4. Arch itectlDesigner's Name
Last vey First Jdf . k Lic. No.
F
Architect/Designer's Address
Architect/Designer's E-mail Address
5z6 N SA4J dq,? 6
Ygar 5sIca 9*,q l cofl,
City WO51 COVI f t(T
State C� Zip %(-1I (ge O Telephone 714)310 _0/ (/
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F_ 5. Engineer's Name Last I
First Lic. No.
F
Engineer's Address
Engineer's E-mail Address
City
State Zip I-- -', Telephone'
F_ 6. Contractor's Name Last I 'iAe/ vqy Sid l t1 el- First I Lic. No. t l2�Jv L class)
Contractor's Address
Contractor's E-mail Address
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r1'eq���d ss @ o��lal. - aw,
City I SOA (�gl e
State C/1 Zip goZgf Telephone 7/y)�tf_Of���
OFFICE USE ONLY
�0� PERMIT NO.
TYPE OF CONSTRUCTION\%
Z0t Ch _ �I �j� PLAN CHECK NO. °
'
OCCUPANCY- GROUP
ZC C•�� ll�/ G" PLAN CHECK FEE $