HomeMy WebLinkAboutF2020-0096 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
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Associated Building Permit# x�o l01 _n Z5 �C Fire Sprinkler [i Fire Alarm r Fire Misc
1. Project Address (Not mailing address) Floor Suite No
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Tenant Name _ -- _..- - - #Units
2. Description of Work
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Valuation $ 6 .��/d 1,1
Extg Sq Ft F 1 New/Added Sq Ft F Total Sq Ft F_--
Zip Telephone
17 New [` Add r Alter F; Demo
# Stories
Check Appropriate Box for Applicant/Notification
3. Owner's Name Last First F_
Owner's Address
Owner's E-mail Address
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City e �jr lCN�
State
Zip Telephone
r— 4. Arch itect/Designer's Name Last
First j� Lic. No.
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Architect/Designer's Address
-
Architect/Designer's E-mail Address
City
State
Zip ��� Telephoned ,
F7, 5. Engineer's Name Last
First F--- Lic No, F_'
Engineer's Address
Engineer's E-mail Address
City
State
Zip F-----_, Telephone I
F-'6. Contractor's Name Last tY� First Lic. No. -74Li ClassFc-
GContractor's
Contractor'sAddress
�Contractor's �E--mail Address
City l�(�`�� IA.�ISW -.
State.
Zip CQ012�v Telephone ��4_S`C? „-�Z �Gi
OFFICE USE ONLY
PERMIT NO.CSI
TYPE OF CONSTRUCTION
PLAN CHECK NO. Dq:51 ' Z�ZF�
OCCUPANCY - GROUP
PLAN CHECK FEE $