HomeMy WebLinkAboutF2021-0197 - Permit ApplicationPrint Form
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Worksheet for Fire Permit Application
City of Newport Beach - Building Division
54 PpRr
m
Associated Building Permit #
7-0Zo - Z-1 ZZ Fire Sprinkler F_ Fire Alarm I- Fire Misc
1. Project Address (Not mailing address) Floor Suite No
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Tenant Name PcAr. N asps. T_a4_ # Units F
2. Description of Work
Use SCE
cPi
g..rt,r>rNrE,. 4" U+sDC-_7_6l�r) SE2vs..16 Z'P7.'SE+z.
Extg SriFt F_New/Added Sq Ft F— Total SolFt
Valuation S 18 k
# Stories n/jq
r New j- Add F_Alter )- Demo
Check Appropriate Box for Applicant/Notification
_3. Owner's Name Last
/{CAA. Ff-osPSTAC- - First -
Owner's Address
Owner's E-mail Address
2 Hr.A6 D'2.
City NE"p�t W,-A<u
State Fop Zip ci2633 Telephone
r 4. Architect/Designer's Name
Last DENS LEiZ First F Lic. No.--
Architect/Designer's Address
Architect/Designer's E-mail Address
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STf. tc�,
City NEAP--T -0c - -t i
State F Gp Zip t- , Telephone 9y9-863-`if3'1
j- 5. Engineer's Name Last
First F_ Lic. No. �-
Engineer's Address
Engineer's E-mail Address
City
State F_ Zip F— Telephoned
F- 6. Contractor's Name Last �E, z First A-� P— .� Lic. No. 19 o 113 Class C- 16
Contractor's Address
Contractor's E-mail Address'
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. I/4tcE,.,z S �F�, c� •�.
City /tAo QtCXZZA
State Fc�— Zip. q / of Q Telephone 6zr. . 35c7- r4fM t
OFFICE USE ONLY
TYPE OF CONSTRUCTION
PERMIT NO. J$j7
d! I U` PLAN CHECK NOCCUPANCY
-GROUP
PLAN CHECK F