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F2019-0113 - Permit Application
rtioici -o I i z, Please print 3 copies Associated Building Permit# Worksheet for Fire Permit Application City of Newport Beach - Building Division 2 g ZC31,S W<Fire Sprinkler ❑ Fire Alarm r! Fire Misc 9 1. Project Address (Not mailing address) Floor Suite No S&C SAP4 Mi7UP 1- (JR _ F— yds Tenant Name I UK,,.7Q0rr O 1.E6z,)C.tq L, 1 Q�. QiAl.P, . ,. # Units F _. _ _ Last - i First-, Lic, No. 2. Description of Work ZZ Architect/Designer's E-mail Address _._.. ------ City... Use C' r Zip �� Telephone d !. Extg Sq Ft F New/Added Sq Ft Fi Total Sq Ft Valuation J7 New i -I Add Alter Demo Stories Check Appropriate Box for Applicant/Notification (- 3. Owner's Name Last First F Owner's Address I Owner's E-mail Address City I - - State Zip � Telephone1 r— 4. Architect/Designer's Name Last - i First-, Lic, No. Architect/Designer's Address Architect/Designer's E-mail Address _._.. ------ City... ----._._.._. ...------ State- Zip �� Telephone d !. r 5. Engineer's Name Last �j p�7O First P,D, T4rr_ Lic. No 5'77( 7_l Engineer's Address Engineer's E-mail Address (oZS `✓�->4N-i7��ei:T �.a - _ _pPl•VIPZIo-�oh�zC�,k_z.G��,coscoi-,>z _. City ��l�iL. _.--. --' State - Zip - [ ���_ Telephone '7I4.�f�! /e0& ['x,116. Contractor's Name Last ,Costo Yii er �iaeT cTio�... First r_', Lic. No. 5774.Z I Class Contractor's Address Contractor's E-mail Address f a `75 �.iaw� a g e r �,n • city State e KV- Zip _ D zeal Telephone OFFICE USE ONLY t>A-qc� t-_-X4-L,<- PERMIT NO. f;(, 1 g • `7--> TYPE OF CONSTRUCTION PLAN CHECK NO145_N��p� OCCUPANCY- GROUP PLAN CHECK FEE $ © �1� '� 1 I