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HomeMy WebLinkAboutF2019-0379 - Permit ApplicationWorksheet for Fire Permit Application City of Newport Beach - Building Division Please print 3 copies_i } r .. Associated Building Permit # (--_-- I f -j Fire Sprinkler j i Fire Alarm (-, Fire Misc 1. Project Address (Not mailing address) Floor Suite No 2o6 l ky6 ere Te✓✓ace---li _ Tenant Name # Units F_ 2. Description of Work __--- �f (e S�ifrf S (o J�C� l lNkle 1S) Jp Use (— F_, Extg Sq Ft � New/Added Sq Ft �; Total Sq Ft �-� Valuation $ IJ ©a New 17 Add r Alter Demo # Stories 2 Check Appropriate Box for Applicant/Notification _ F. 3. Owner's Name Last-- ;First Owner's Address i Owner's E-mail Address City ---- State Zip Telephone F_ 4. ArchitecUDesi9 War's Name Last V0 First CTM —, Lic. No. F Architect/Designer's Address �2& Al jltdy_ 4/e Avz Architect/Designer's E-mail Address vet c,; City weS f CPV( yl A _ �i'/e leds',�Ca9nZialI, _ State 0w zip 9171 7o Telephone Fom) ,311lO -6v y F 5. Engineer's Name Last 7—­77-7—First ____ F-- Lic. No. F_, Engineer's Address Engineer's E-mail Address ' City_ State--_... Zip Telephoner .. 6. Contractor's Name Last ✓e%UC1fR�y rN [�(�✓ First �— — - Lic. No. Class Contractor's Address lJ ff Ur dwi Contractor's E-mail Address 7_ QCe_ City �P- ll -SS Ott-{� State. Zip c(�f. j Telephone 311, -01 �oz� [C1iY 31-01q, OFFICE USE ONLY ��(�� PERMIT NO. n TYPE OF CONSTRUCTION OCCUPANCY -GROUP "T PLAN CHECK NO. ' �� PLAN CHECK FEE $