HomeMy WebLinkAboutF2018-0588 - Permit ApplicationPriht Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Wire Sprinkler ❑ Fire Alarm
2 551-2018
FZO180588 ,,EWER.
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❑ Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Owner's Address
Tenant Name3 1���K ';�L2�� # Units
/ 7 v
toff
2. Description Work
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City � �a �711.�/%' StateE�K
Use
Zip F77 Telephoned 3 y 7
/C7
F_74. Architect/Designer's Name!- Last—�
Valuation $ is
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Extg Sq Ft FI -ti New/Added Sq Ft Total Sq Ft O
New ❑ Add Alter Demo
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# Stories 1 :.1
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Check Appropriate Box for Applicant/Notification
❑ 3. Owner's Name Last LBA-0) I First w
Owner's Address
Owner's E-mail Address
City � �a �711.�/%' StateE�K
Zip F77 Telephoned 3 y 7
/C7
F_74. Architect/Designer's Name!- Last—�
First F7771 Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
--
city 7 State
-
---
Zip [�� Telephoned
5. Engineer's Name Last
First F Lic. No. F__7
Engineer's Address
Engineer's E-mail Address
City _ State
Zip[__ Telephoned
j6. Contractor's Name Last / yA/t�/ �<
First �/ Lic. No. �i lass C
Contractor's Address
Contractor's E-mail Address
City L`ev�I) , State
Zip (r �� Telephone � �
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY- GROUP
PLAN CHECK FEE $
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