HomeMy WebLinkAboutF2019-0169 - Permit Application (2)Print Form Worksheet for Fire Permit Application
Fl.o�c1.O' &�1 City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # r- Fire Sprinkler F_ Fire Alarm r Fire Misc
1. Project Address (Not mailing address) ECEM E!Floor Suite No
y'1?U Ivew1pr4 13471". _ APR 2 4 2019- �-
Tenant Name I &U)Pdd F72/)1i �NwW �d�,n' INTERWEST #Units
GONSI 11 iING GROUP
2. Description of/Work
Zip F Tele'phoneF
onof
'' !''� I _ ";20 1:�,vtty-_fJ
Use
Extg Sq Ft ��' New/Added Sq Ft F Total Sq Ft F
Valuation $
r- New Add Alter F_ Demo
# Stories r
Check Appropriate Box for Applicant/Notification
Infnrmn inn
F_ 3. Owner's Name Last
First F
Owner's Address
Owner's E-mail Address
City [ State F
Zip F Tele'phoneF
F_ 4. Architect/Designer's Name Last First �' Lic. No.
Architect/Designer's Address
Architect/Designer's E -m Address
City /S"7� J� l State I
Zip o `I / �r Telephone
r 5. Engineer's Name Last
First Lic. No.
Engineer's Address
Engineer's E-mail Address
P
City f ..-. State �
Zip �� Telephone
6. Contractor's Name Last �� First r/ �', Lic. No. 1�9r 6, Class Fe ID
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Contractor's Address
Contractor's E-mail Address
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City 1 &OPJ4 State F-9—
Zip ? w Telephone I/C/-r� r �7q'
OFFICE USE ONLY
PERMIT NO. �� I
TYPE OF CONSTRUCTION �L I�Y�l1L� PLAN CHECK NO. 0760 — 7yD p
OCCUPANCY - GROUP
PLAN CHECK FEE $
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