HomeMy WebLinkAboutF2020-0484 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # I VR/0,0 — It JTI Fire Sprinkler n Fire Alarm r; Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Tenant Name ! #Units F
2. Description of Work
- i
Use ...... .... ... ''.
fI'—
EMg Sq Ft New/Added Sq Ft F Total Sq Ft l
Valuation $
/ - - -
New (` Add r: Alter r7 Demo 31 6 1, U�
Stories F
Check Appropriate Box for Applicant/Notification
I nfnrmn4i nn
3.Owner's Name Last f ' tt/ Z��
First (
Owner's Address
Owner's E-mail Address
/
City State—�
Zip�6{j Telephone
i— 4. Architect/Designer's Name Last I First F Lic. No.
- -
Architect/Designer's Address
Architect/Designer's E-mail Address
City _ -. State F_
Zip F— Telephone[—
F_, 5. Engineer's Name Last
First Lic. No. F _
Engineer's Address
Engineer's E-mail Address
City a State--
Zip Telephone'
I—':6. Contractor's Name Last First Lic No. Class
MGSTD% 2Gt� 10��f609 �
Contractor's Address
)
Contractor's E-mail Address C 1 (p
City _ .f f I .1-50 _ I / l g-V --.. State F—'
u �J
Zp 7 �j�p Telephone q_qq _-j7,-:5 ?j-) J
OFFICE USE ONLY
PERMIT NO. 1 tt,0_ 0 - D y Sy
TYPE OF CONSTRUCTION
PLAN CHECK NO. E v ' '
OCCUPANCY - GROUP
PLAN CHECK FEE $