HomeMy WebLinkAboutF2020-0356 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Divici3�
Please print 3 copies F O U'✓JUG oa""
Associated Building Permit # Fire Sprinkler r Fire Alarm r, Fire Misc
1. Project Address (Not mailing address)
-/0Ar9-_ (Wesr _W1a01 W.4 y _
Tenant Name [ 14 e J C I�eS(deo�
2. Description of Work 1t7 U•w('(
New ,A�&0-10- n" r'.c
Extg Sq Ft New/Added Sq Ft', Total Sq Ft
7 New (- Add r Alter F- Demo
Check Appropriate Box for Applicant/Notification
�Flo-or Suite No
#Units I
Use
Valuation $
# Stories
F_ 3. Owner's Name Last
First
Owner's Address
i
Owner's E-mail Address
City �— State I '-
Zip F— Telephoned
r 4. Architect/Designer's Name Last
t ; FirsLic. No, i
Architect/Designer's Address
Architect/Designer's E-mail Address
City �— State F �
Zip Telephone
I`; 5. Engineer's Name Last G 12(S SOM
First O
FA v/, Lic. No.
Engineer's Address
Engineer's E-mail Address
City Fl _n 1N(�L... _ State I ,/i
zip 9�G.OG Telephone 7/&1- 433-420eS
6. Contractor's Name Last
r-
First S C4n Lic No. ��� j Class
Contractor's Address
f
Contractor's E-mail Address
MMI _-rw.5evS _oti __
SF:e/ K 14-cu ll.-irueAi0-LOC ta.,/ ca —
City (. State
(3Ch 4
Telephonepu.Nr.
C,171&1 , qo-7 -15 F&
OFFICE USE ONLY � I PERMIT NO. 114 • i/
•
TYPE OF CONSTRUCTION
♦ � PLAN CHECK NO.
OCCUPANCY -GROUP
PLAN CHECK FEE $
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