HomeMy WebLinkAboutX2019-2350 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division , � / Z r y
9< FOPP�
.ng Permit -,,✓
F— Fire Sprinkler Ai Fire Alarm f- Fire Misc
ct Address (Not mailing address)
Floor Suite No
ItTenant Name—"----;
- _... #Units f _.
2. Description of Work
r1s Usef%�f
Extg Sq Ft New/Added Sq Ft Total Sq Ft Valuation $ f�
F_ New r Add Alter Demo # Stories i !
Check Appropriate Box for Applicant/Notification
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(- 3. Owner's Name Last • F I) r'
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Owner's Address - -
II Owner's E-mail Address
City
State ��
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Zip �..,�� Telephone! �'y-
4. Arch itect/Designer's Name Last r--- 1 —
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Architect/Designer's Address First LicNoF-
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Archite ,t/Designer's E-mail Address
City State �.._—.
i -. Zipl Telephone,
F 5. Engineer's Name Last �`�/ '
First 1. t�,t
7 c. No.
Engineer's Address --
Engineer's E-mail Address
City �,+.,'y� State v'. .. q
-- Zip.. `,� y rte' Telephoned y �at, e t el el,
F 6. Contractor's Name Last I d`y
_3 d'`Z=firstl Lic.No.5�,%y1Class�._.�...—._
Contractor's Address / /'
Contractor's E-mail Address
City
StateZip
- ... ZipTelephone
=FICE USE ONLY
PERMIT NO.
'F OF CONSTRUCTION
'ANCY -GROUP PLAN CHECK NO. —_
PLAN CHECK FEE $