HomeMy WebLinkAboutF2019-0293 - Permit Application—tWorksheet for Fire Permit Application oaeW��
(2 4111 City of Newport Beach - Building Division
Please print 3 copies ;FoaN
Associated Building Permit # i Fire Sprinkler r Fire Alarm r i Fire Misc
1. Project Address (Not mailing address)
L(_I a--Lf ST- -_
Tenant Name
2. Description of Work
Extg Sq Ft New/Added Sq Ft Total Sq Ft
New F_ Add r Alter Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
# Units
Use _
p�
Valuation $ j
# Stories
F7 3. Owner's Name Last
! First F
I
Owner's Address
Owner's E-mail Address
City �- _
State
Zip F_Telephoned
F_ 4. ArchitecVDesigner's Name
Last
1 First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City �—
State F_
Zip r— TelephoneF_Y
F 5. Engineer's Name Last
�
First F Lic. No. F_
Engineer's
(Engineer's E-mail Address
City
-...
�_—
State
_.
Zip F—; Telephoned _.. _... _..... .
6. Contractor's Name Last V First Lic No. Class G
Contractor's Address
Contractor's E-mail Address
.lV. G'. �1-�'�-.f3.0'�
S . __._. _'....
Fl CB•-'�'T e—Tt ,.� a °�'ftdv....Cowes
city �� �,,,n .�
State �G�
Zip l�0,( Telephon j1.j� 7®,:�- -=7it/
OFFICE USE ONLY
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PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO. ►
OCCUPANCY- GROUP
10
PLAN CHECK FEE $