HomeMy WebLinkAboutF2018-0585 - Permit ApplicationF Zo 14�70 -ovw_-)�V-)
Print ForF71 Worksheet for Fire Permit Application o4?EW�_4
City of Newport Beach - Building Division
Please print 3 copies '� I., ,,
Associated Building Permit # �)I [ Fire Sprinkler ❑ Fire Alarm Fire Misc
1. Project Address (Not mailing address) Floor Suite No
—_v--. L 1 � i� i f f 1� i2 7
Tenant Name _ - #Units I I
L I
2. Description of Work
Use
_
0V-', k< ,� r7r S Da,wrr t�> �`S <�if
— --
Valuation $ 9 Dap
Extg Sq Ft New/Added Sq Ft Total Sq Ft �� 5'S y'
7 New [ Add i] Alter M Demo
#Stories EF
Check Appropriate Box for Applicant/Notification
1..4........4'....
3. Owner's Name Last /V� U l� FirstR7/;1
Owner's Address Owner's E-mail Address
City - State �� Zip [":777-7 Telephone
4. A¢B0tl3ct/ signer's Na Last E727-4-1-74- First gy Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City _ _ _ _ _ State !� Zip Telephone��
❑ 5. Engineer's Name Last First Lic. No.
��II
Engineer's Address Engineer's E-mail Address
City�— --, State Zip C— TelephoneF7—
[6.Contractor's Name � Last I-- First Grq.y+ J Lic. No.C,92!2F Class
Contractor's Address Contractor's E-mail Address
r'12 .� a �� C ,lti -�. y /7 r
City State Zip ' v / Tele hone (2G
/ L 7/ Z Y 9G
._---- -------- — P
O ICE USE ONLY �qt��^' PERMIT NO. l
E OF CONSTRUCTION
J� �j PLAN CHECK NO.
^ /
OCCUPANCY- GROUP X -% ��`� tJ PLAN CHECK FEE $
t,) Z®,.lt5-I `tiZZ�
it