HomeMy WebLinkAboutF2019-0321 - Permit ApplicationF2 -0(q 03(L1
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
X Z -o 1 C) - ®/ tp 'L ! _ Fire Sprinkler (.-I Fire Alarm rl Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Check
,
wrr-,r eo tL--r ��11 �_� .� � C2�pl
Tenant Name # Units
2. Description of Work
Owner's E-mail Address
Use !,
-r�-
%/�e"r;�.RtNk���. 6 .�• � ��/y�s j
Extg Sq Ft �—_ New/Added Sq Ft � Total Sq Ft �—'�
Valuation $ 41'"J
'1 i
FNew F' Add F r-" Demo `l- n
Stories
57\-2-
l 1Z
Check Appropriate Box for Applicant/Notification
F-1 Owner's Name Last �—
- First F--'
Owner's Address
Owner's E-mail Address
City �—
State —i
Zip -- TelephoneF
F_ 4. Architec esi ner's Nam Last
3y p First :Fm, Lic. No.
Architect/Designer'ss Address
Architect/Designer's E-mail Address
City
State E
Zip��� �.._
� �� Z l ... Telephone 7r � i L�c�J,
F 5. Engineer's Name Last
First --_ Lic. No.l
I
Engineer's Address
Engineer's E-mail Address
City --.-
State (
Zij—_-.__ Telephoned~
F-1 6. Contractor's Name Last {;a5e o 6,,e z. 56 rIZtT)oN First____- Lic. No. r y 6-Lj Class
Contractor's Address
lD`Lrj -fes?6FR�
t��
Contractor's E-mail Address
C�Mo/}L1�LCa1caT"rZe-•oars
City
State �—
Zip z �z ( Telephone Y 1917 2W
OFFICE USE ONLY
PERMIT NO. - Ua� L
TYPE OF CONSTRUCTION
PLAN CHECK NO. IZIZ " TiU� c�
OCCUPANCY- GROUP
PLAN CHECK FEE $