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HomeMy WebLinkAboutF2018-0332 - Permit ApplicationWorksheet for Fire Permit Application i?nnt P#iirft, City of Newport Beach - Building Division Please print 3copies li��� 0332, Associated Building Permit # Fire Sprinkler ❑Fire Alarm r7 Fire Misc 1. Project Address (Not mailing address) Floor Suite No 1242 Owner's E-mail Address Tenant Name City�1�7�.�LLtiS/_IJ5�� � Pi U f%O� f -eo e_T,_ _', State # Units F- 2. Description of Work Architect/Designer's Address Architect/Designer's E-mail Address S 're-SP�rV�lo✓ s�Si��� lupi �'�$ .�.. �arE N��g; Use - - - 64 g Valuation $ —' Extg Sq Ft New/Added Sq Ft ! ��8 Total Sq Ft C d City ® --- _ State # Stories New ❑Add FJ Alter ❑Demo Contractor's Address Contractor's E-mail Address Check Appropriate Box for ApplicanVNotification -------------- ❑ 3. Owner's Name Last First � Owner's Address Owner's E-mail Address City�1�7�.�LLtiS/_IJ5�� � Pi U f%O� f -eo e_T,_ _', State Zip 9�%-(�6aelephon i,q) 612- F14. Architect/Designeeshame Last C �r_SO to First— Lic. No. C52 -7Y - - Architect/Designer's Address Architect/Designer's E-mail Address Caro a vt�{cn,l,_ Ave— -- -a- - F,9:-t**l City �• t \- \ � State C Zip I -- _q0 Telephon -6Z) +j �( (,- o ] c(rj ❑ S. Engineer's Name Last First�Lic. Engineer's Address Engineer's E-mail Address C d City ® --- _ State ZIP ', Telephon %y�- 31 : � � ❑ S. Contractor's Name Last-T(q First S er� © Lic. No. I®� Mass - -- -1 -- — C Contractor's Address Contractor's E-mail Address 16q83- s4ri-ec�let_ 5 � b 1ob� 1 y1 �{-_ City \CState bl 1 _ -- GLI/�C\ Zip '23C/ / Telephon q c( Ki 1 OFFICE USE ONLY V W l i ') , 0,53 S PERMIT NO. �0 ?7 TYPE OF CONSTRUCTION PLAN CHECK NO. OCCUPANCY- GROUP 2 �� i ✓ �J S { PLAN CHECK FEE $ r3 �oob3uj y