HomeMy WebLinkAboutF2020-0135 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application o
City of Newport Beach - Building Division � l �q�
_
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Fire Sprinkler F Fire Alarm r Fire Misc
1. Project Address (Not mailing address)
Tenant NameU
2. Description of Work
Extg Sq Ft �— New/Added Sq Ft F Total Sq Ft
PK New r Add r Alter r Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
# Units
Use
Valuation$ ('G-�,3(nT
# Stories F
F- 3. Owner's Name Last I _ First
Owners Address
' Owner's E-mail Address
I � CGtC✓����
City �c-r State
FZ7 Zip— Telephone---
r 4. Architect/Designer's Name Last
First Lic. No. �—
Architect/Designer's Address
Architect/Designer's E-mail Address
City State
F Zip F Telephoned
(- 5. Engineer's Name Last �-
First Lic No.
Engineer's Address
Engineer's E-mail Address
City �— State
F_ Zip F_ Telephoned
6'Contractor's Name Last /� First P t Lic. No. IO376+Z7 class -/7
Contractor's Address
Contractor's E-mail Address
IZ3 C^ CenJnt� li�c
Guviw�7 Gaiy�'w.y �n('evayr've.
City P,04Y✓/w State
F(Z Zip �!� Telephone W%- 3Sj•NoYS`
OFFICE USE ONLY
/�1I ✓ PERMIT NO. ti02o ' D 1055
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TYPE OF CONSTRUCTION
`��1 PLAN CHECK NO. �1 /
OCCUPANCY - GROUP
I A 13 It r PLAN CHECK FEE $
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Print Form
Please print 3 copies
Associated Building Permit #
1. Project Address (Not mailit
I cllet-ham ury
Tenant Name
2. Description of Work
Worksheet for Fire Permit Application o4�EW�Re
City of New-poortt Beach - Building Division
ein ��v,'stor� �o••.�
Fire Sprinkler r Fire Alarm r Fire Misc
address)
Extg Sq Ft �— New/Added Sq Ft Total Sq Ft F—
r New r Add j-" Alter r Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
# Units r
Use
Valuation $
# Stories
r 3. Owner's Name Last
First F
Owner's Address
Owners E-mail Address
City
State F_
Zip F Telephoned--
r 4. Architect/Deslgnees Name
Last
First 7 Lic. No. —
Architect/Designer's Address
Architect/Designees E-mail Address
City
State
Zip F_ Telephone
I— 5. Engineer's Name Last
First F— Lic. No. �—
Engineer's Address
Engineer's E-mail Address
City
State F__
Zip F— TelephoneF—
f— 6. Contractor's Name Last �i z First Cf tJ Lic. No. (p3� �z) Class
Crctty
Pvc- wn+�w
Contractors Address
Contractor's E-mail Address
/
l Z 3. C-G'G-�✓ct (
LC' An 6 r 1,a t)
City Pn__;r4—.0
State I L1K�
Zip Gir!U [(a Telephone 6 _:3 S04/�
OFFICE USE ONLY
PERMIT NO. WiD 1117owd
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $