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HomeMy WebLinkAboutF2018-0674 - Permit ApplicationW Worksheet for Fire Permit Applicati City of Newport Beach - Building Division Please print 3 copies ZD V - © SZV l % � yi1 Associated Building Permit# �� � SC( Z, , ire Sprinkler � Fire Alarm ire Misc 1. Project Address (Not mailing address) Floor Suite No /&_ OL _C s` JZ S t > (_ F Tenant Name # Units �— `,6�4;L �2�5(��N� 2. Description of Work Use I�El6cc-`�lo.v �Y nl-ST"-&- .Fivic— _ vt,' l�:i+;1 - Valuation $— Extg Sq Ft F_ New/Added Sq Ft � Total Sq Ft F_ # Stories ( L � New r Add J_ Alter [-• Demo Check Appropriate Box for Applicant/Notification f- 3. Owner's Name Last i f First cal Owner's Address Owners E-mail Address City _ State I Zip F Telephone "I LIi l 4. Architect/Designer's Name Last First F Lic. No. �— Architect/Designers Address Architect/Designer's E-mail Address City State �— Zip �— Telephoned r 5. Engineer's Name Last y��'GL-/ First �'� �I= �_ Lic No. j Engineers Address Engineers E-mail Address r City � ✓%a,J.� � ._ .. State CL.A-IVWa'1[�, Zip Y.c� 6� Telephone 9Jri'I �C53- S-2 (- 6. Contractor's Name Last ( �� ,� First 5 L_ Jj J Lic No. g?g j'�3 Class / Contractor's Address Contractor's E-mail Address - city !� ,/S State Zip �,�Gy Telephone. -Z /I L� ,,7 -7 PERMIT NO. � /� b7yP OFFICE USE ONLY pp TYPE OF CONSTRUCTION PLAN CHECK NO. OCCUPANCY - GROUP PLAN CHECK FEES