HomeMy WebLinkAboutF2020-0483 - Permit ApplicationPlease print 3 Copies
Associated Building Permit#
1. Project Address (Not
Tenant Name
2. Description Of Work
Worksheet for Fire Permit Application
City of Newport Beach - Building bivljj,-
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n Fire Sprinkler 0Fire Alarm nFireMisc:
address)
Extg Sq
Ft j New/Added Sq Ft _77 Total Sq Ft
r7 New Add F7 Alter F_
p .. � Demo
leck Appropriate Proprla
Box for Applicant/Notification
[--(1 3. Owner's Name Last
Floor Suite No
# UnitsF 7_7
Use
Valuation $ 1, 1
# Stories
9-, — Cp 0
Owner's Address First
— — — — -- — �__n Owner's E-mail Address
City
77 Zip -------
State F Fq � f
F74.ArchitectlDesigner's Name Last Telephone
Architect/Designer's AddressFirst
Lic. No.
Architect/Desi
ner's E-mail Address'
city
------ State zjP Telephonef,!,
Engineer's Name Last
First
]—,a Engirlear's E-mail Address
Engineer's Address (W -a-Z 7CE§ 5 Lic. No,
/03 �70q
city Pr
_—!'6. Contractor
----- II _29 state Zip -- — ------ Telephone
's NameLast First
Contractor's Address J 1c, No. Class
Contractor's E-mail Address
---- -- - ----
City
state
_771 Telephone
------ - Zip r
OFFICE USE ONLY
TYPE OF CONSTRUCTION PERMIT NO.
OCCUPANCY -GROUP . PLAN CHECK NO.
L7----0Q5L PLAN CHECK FEE $