HomeMy WebLinkAboutF2019-0224 - Permit ApplicationWorksheet for Fire Permit Application
Print Form-- City of wport Beach - Building Divisio�ry
Please print 3 copies a '
Associated Building Permit # r -- F7`Fire Sprinkler r`� iire/Alarm F- Fire Misc
t. Project Address (Not mailing address) / J� V e r
7-RvC!-
Tenant Name
2. Description of Work
Gvv �A G A
Extg Sq Ft F— New/Added Sq Ft
j/ New F_ Add r Alter r Demo
Check Appropriate Box for Applicant/Notification
F_ 3. Owner's Name Last
Owners Address
U01"
Suite No
#
Use
Valuation $ yao�
TotalSgFt 2,dw
# Stories F
First
Owners E-mail Address
City F— State F Zip Telephonel--------
j_ 4. Architect/Designer's Name Last f ------.�.-- � First �— Lic. No.
Architect/Designer's Address ArchitecUDesigner's E-mail Address
City
State F_ Zip F TelephoneF
f— 5. Engineer's Name Last I First I Lic. No.
Engineer's Address Engineers E-mail Address
y State F_ Zip F_ TelephoneF_
Contractor's Name Last /� -,,I t__
,tor's Address
t L (f NTNZ N} . 1}`ri
,A"N j2v v , ^r
ONLY
)NSTRUCTION
- GROUP
State — Zip
First Lic. No. F1017 82M Class
Contractors E-mail Address
11 t o ((, Telephone �,Z,� S Ito -A J
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEE $
M
u