HomeMy WebLinkAboutF2019-0151 - Permit ApplicationPlease print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
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(-i Fire Sprinkler [i Fire Alarm Fire Misc
1. Project Address (Not mailing address) Floor Suite No
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1� Units �r #
Tenant Name '�b1e-. � \-.� _...... -.-._.
2. Description of Work
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Use
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Valuation $ WY
Extg Sq Ft New/Added Sq Ft Total Sq Ft
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# Stories
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New F (! Alter r Demo
Check Appropriate Box for Applicant/Notification
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3. Owner's Name
Last �—
First
Owner's Address
Owner's E-mail Address
City
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F Telephoned
4. Arch itecUDesigner's
Name Last -.-�, v\�,e�� First C i �G' Lic No.
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Architect/Designer's Address
Architect/Designer's E-mail Address
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City V�"�t -d
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State Zip
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l��� Telephone
F 5. Engineer's Name
Last �
First F_ Lic. No. F_
Engineer's Address
Engineer's E-mail Address
City _.
State-- Zip
�— TelephoneF�
r— 6. Contractor's Name
Last'
First Lic No. I ,. Class
Contractor's Address
Contractor's E-mail Address
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State IC Zip...A%
Telephone qV7 5055
OFFICE USE ONLY
PERMIT NO. I of a 01 :5 1
TYPE OF CONSTRUCTION PLAN CHECK NO. l
OCCUPANCY- GROUP
PLAN CHECK FEE $