HomeMy WebLinkAboutF2018-0322 - Permit Application0322 li
Worksheet for Fire Permit Application o�
Print Form City of Newport Beach - Building Division o a
�9<FOPN.P
Please print 3 copies
Associated Building Permit # [71Fire Sprinkler ❑ Fire Alarm ❑ Fire Misc
Floor Suite No
1. Project Address (Not mailing address) r--, F_7 '
# Units
Tenant Name (��^ Sri �'�Gc�
2. Description of Work
Use
Valuation $
Extg Sq FtF_J New/Added Sq Ft —� Total Sq Ft
#Stories
�ew E] Add F] Alter ❑ Demo
Check Appropriate Box for Applicant/Notification
❑ 3. Owner's Name Last �C,0 �-rn�w& First
Owner's Address
City V. g State
Owner's E-mail Address
Zippty(yty Telephone
❑ 4. Architect/Designer's Name Last—� First Lic. No.
Architect/Designer's Address
City State F7777
Architect/Designer's E-mail Address
Zip F7_71 Telephoned
❑ 5. Engineer's Name Last First Lic. No.
Engineer's Address
City State F
❑6. Contractor's Name Last
Contractor's Address
City `�w'�,�.`hs State
OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY- GROUP
Engineer's E-mail Address
Zip � Telephone[ ._
7 FirstF Lic. No. 1�cd Class
Contractor's E-mail
Zip I Telephonen \ %j
,gun 221%
e -D,1 V / V's
PERMIT NO. 7;� vv��
PLAN CHECK NO. M'E_ Zo18
PLAN CHECK FEE $