HomeMy WebLinkAboutF2020-0464 - Permit ApplicationPlease print 3 copies V
Associated Building Permit #
Worksheet for fire Permit Application
1 City of Newport Beach - Building Division
�—
Fire Sprinkler )7 Fire Alarm [�; Fire isc
1. Project Address (Not mailing address) Floor Suite No
Last j First:
Tenant Name��(f '% 'T s. 5� # Units F-
2. Description of Work
City StateF`1 Zip Telephone( _—�—
F_ 4. Arch itect/Designer's
Use
,, /�/`l(/q
ii/1W lvrvA-17C 6rite �,U✓�,v�L+PiI 5y�>ccy�t
EMg Sq Ft �� New/Added Sq Ft � � Total Sq Ft ��
Valuation $
-
[i New F- Add i- Alter F_ Demo
# Stories I T
Check Appropriate Box for Applicant/Notification
3. Owner's Name
Last j First:
Owner's Address
Owner's E-mail Address
City StateF`1 Zip Telephone( _—�—
F_ 4. Arch itect/Designer's
Name Last First j Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
I
State I Zip F Telephone
F7 5. Engineer's Name
Last On r?sv✓v\ First Lic. No. F
Engineer's Address
- Engineer's E-mail Address
i5 �l�ru� _ �Gic sr 1 5vu� 'ce. �Ia v,c�•�
City
r
-
State Zip TelephoneF�/9-0$3,-00EJ
6. Contractor's Name
Last FW -r LL Lj First 5 V Lic. No. F�7i ! Class
Contractor's Address
Contractor's E-mail Address
i�C�l.l--.�fL`'SEL'._.
-- 2—_ __ `5�1:i'�n—'I<-�l=%� `�% -� ✓rcr�-cGrSu.u. c...--�
City14 LIN! . _! i y
_... state I //a ._ !'' Zip TelephoneI .(?� �0
OFFICE USE ONLY
PERMIT NO.� •6
/L
TYPE OF CONSTRUCTION PLAN CHECK NO. ' I qhu
OCCUPANCY- GROUP�Oy
y PLAN CHECK FEE $