HomeMy WebLinkAboutF2019-0024 - Permit Application�Ew
Worksheet for Fire Permit Application
Please print 3 copies o� e�
City of Newport Beach - Building Division
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Associated Building Permit # JVFire Sprinkler h Fire Alarm Fire Misc
1. Project Address (Not mailing address)
!' ' GDI _ � I_�-
Floor
Suite No
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.
Tenant Name �.pf/i.1'`
2._
# UnitsI IV
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2. Description of Work
11
V,31
Use Fries - __-
Valuation $ (g
D '-17
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Extg Sq Ft New/Added Sq Ft F7777 Total Sq Ft
Iia
New Alter F -Demo
# Stories
r r/Add )!
Check Appropriate Box for Applicant/Notification
I—••'•.: 3. Owner's Name Last[ First
Owner's Address Owner's E-mail Address
Yls� M -o., �' KV -4 �t LCA i
City Nle' State ' Zip of 2f.,e-CDS Telephone
F- 4. Architect/Designer's Name Last �— First Lic No.
Architect/Designers Address ArchitectlDesigner's E-mail Address
City i State F—. Zip F_ Telephoned
r 5. Engineer's Name Last First Lic. No.
Engineer's Address (y /i Engineer's E-mail Address IIII
City _ _ State �! Zip Telephone -
. Contractor's Name Lash First y�MGg Lic. No. FZ_((Zy Class C-1 C¢
Contractor's Address Contractor's E-mail Address
�S I-r-,w'.S _CT.._- -- - --- ^15iT�uCirUJ�eJscti �ss�roV�.CoopA
City State—', Zip �g{s.Z Telephones tri `73
OFFICE USE ONLY 1 •$ s�7r Z PERMIT NO. L
TYPE OF CONSTRUCTION PLAN CHECK NO.
OCCUPANCY - GROUP PLAN CHECK FEE $