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HomeMy WebLinkAboutF2019-0494 - Permit ApplicationPrint Form Please print 3 copies Associated Building Permit # Worksheet for Fire Permit Application City of Newport Beach - Building Division fill -ow "'14 r✓�Fire Sprinkler F_ Fire Alarm r Fire Misc � 9 G4vp0.N�P 1. Project Address (Not mailing address) Floor Suite No �/� ��j/t@ 1 Tenant Name # Units — -- Owner's Address 2. Description of Work "'• Use �g 3 (_e l/l �� ,_ r 4. Architect/Designer's me Extg Sq Ft New/Added Sq Ft Z/3 1 I Total Sq Ft Valuation $ New r Add r Alter F_ Demo # Stories F 3 Check Appropriate Box for Applicant/Notification Iri�rm.�4'�n F_ 3. Owner's Name Last �/� ��j/t@ 1 First Owner's Address Owner's E-mail Address City State Zip Telephone r 4. Architect/Designer's me Last d� First I� Lic. No. �-.-- Architect/Designer's Address Architect/Designer's E-mail Address City I State F_ Zip I e F 5. Engineer's Name Last First I� Lic. No. C-. -- Engineer's Address Engineer's E-mail Address v City f State Zip �— Telephone 6. Contractor's Name Last ��� �� First Lic No. °% '5 33 ClassF6 16 Contractor's Address Contractor's E-mail Address 11,7 i�✓G�� G� - h7 JIB City �� �i�� �(� S State Vv4_ Zip gjl-7L1 y Telephone ��_ OFFICE USE ONLY �p , PERMIT NO. ` < TYPE OF CONSTRUCTION y✓ PLAN CHECK NO. OCCUPANCY- GROUP PLAN CHECK FEE $ A PJ C '"L L