HomeMy WebLinkAboutF2021-0308 - Permit Application;tPnrityF r,�n,, �;
Please print 3 copies
Associated Building Permit It
1. Project Address (Not mailin
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
address)
Tenant Name (- V" d e_vkGe
ZS
2. Description of Work
�zs��v. G;K iwS-ice(( G l3n.Q Tre �f�`�•.�(e�-
SY�t-1eads
Extg Sq Ft �_-- New/Added Sq Ft 1 &0 p Total Sq Ft (9��
(- Fire Sprinkler r Fire Alarm r Fire Misc
New F Add r' Alter F_ Demo
AL __
^MN'"M"a« WUA rvr mppncanVIVOTITICation
Floor Suite No
# Units r
Use y
Valuation $ _3i c
# Stories S
F_ 3. Owner's Name
Last
First �—
Owner's Address
Owner's E-mail Address
City
State F_ Zip
�— Telephone[—
F_ 4. Architect/Designer's
Name Last tc cr First - t�, Lic. No.
Archit�
e/ctlDDesigner''s Address
Architect/Designer's E—mail Add-d+ress
p
/� �i
// {
City
rT 1/Iat-Ic..ivK -State - I Cp� ZIP fqZ� Telephone Z('T(93C)-,'�l(�
r 5. Engineer's Name
Last r---
First F— --
Lic. No. F--
Engineer's Address
Engineer's E-mail Address
City F_
State F_ Zip
F_ TelephoneF--
F 6. Contractor's Name
Last Q�
First Ati�ti Lic. No. FWVp 3 Class C(
Contractor's Address
Contractor's E-mail Address
uu,
City NV�.�2.�
State L� Zip
lZbvp Telephone-711_6-jQ/
OFFICE USE ONLY
PERMIT NO. 030
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY- GROUP
�j O q O
PLAN CHECK FEE $
VU16'0lU0 4U1,