HomeMy WebLinkAboutF2018-0461 - Permit Application198o,vo
Worksheet for Fire Permit Application EW18-O4G6
Print Form City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit # ❑ Fire Sprinkler ❑ Fire Alarm ❑ Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Tenant NameI (Jr�j 3'!f L,4L #Units
2. Description of Work
t
Use
Valuation $ �L-
Extg Sq Ft �— New/Added Sq Ft Total Sq Ft
❑ New ❑ Add Alter Demo
# Stories
❑ ❑
Check Appropriate Box for Applicant/Notification
❑ 3. Owner's Name Last
Owner'sAddress�
Owner's E-mail Address
F777
City �/'�,r_ �4ppppS
tate
�����-y/�!'.---------zip TelephoneF_
❑ 4. Architect/Designer's Name Last �� First L
ic. Lic. No.�
Architect/Designer's Address Architect/DestE-mail Addres
_ _ I
City _ _ _ _ 1 State F_ 71 Zip [77777 Telephoned
❑ 5. Engineer's Name Last First I Lic. No.
Engineer's Address Engineer's E-mail Address
-77
City State F-7 Zip E Telephone
❑ 6. Contractor's Name Last First Lic. No. ClassF�E �
Contractor's Address Contractor's E-mail Address
, �F,'AZU
City �.�5 .Q�n State 1� Zip Iy,�, Telephone
OFFICE USE ONLY®7 h 1 PERMIT NO.
TYPE OF CONSTRUCTION zt \ PLAN CHECK NO.
OCCUPANCY - GROUP 7 (fit 'Y�1 PIAN CHECK FEE $