HomeMy WebLinkAboutF2019-0253 - Permit ApplicationPrint Form Worksheet for Fire Permit Application
Fs� City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit #
%10*Fire Sprinkler I - Fire Alarm r Fire Misc
u
1.Projectt mailingFloor Suite No
zare_ _
2daJ� F_jZ
Tenant Name # Units F — -
Owner's Address
2. Description of Work
City
r/aCF SIA -KICK r Ai-tT �.oJ�W�Rr-11, Coil P4EAJ'>-,%
UseC._,r,
r 4. Architec Designer's Nam
Valuation $ 5/_8Sop
Extg Sq Ft New/Added Sq Total Sq Ft r,
# Stories
New r Add
� j�-Iter � Demo
Check Appropriate Box for Applicant/Notification
r 3. Owner's Name Last
First
Owner's Address
Owner's E-mail Address
City
State Zip F-- Telephonel�,
r 4. Architec Designer's Nam
LastS r irl ay t �, First �p >` it Lic..No.
57762 1
Architect/Designer's Address
Architect/Designer's E-mail Address
toLnvn6r-.P;T
2p, casc0riks,eo/V1
City
State ,�� Zip 97-5ZI TelephoneFt`{qs? )goo
F_ 5. Engineer's Name Last
First Lic. No.
(---
Engineer's Address
Engineer's E-mail Address
City
State ��' Zip � TelephoneF_
6. Contractor's Name Last 6sca F«rz % c2n i rwl j o.1 First Lic. No. 5_,7GZf Classrr
�b'
Contractor's Address
Contractor's E-mail Address
{o75 V-1'ZA�-itoF PI
2D , I Cosaa F_ - Ca V--\-
City ��1✓{4,,
State FCA Zip I q •Z7 q'V Telephone 7 f-1 q$°I t s 0
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
��j/� PLAN CHECK NO. a
`/fXf/)
OCCUPANCY- GROUP
4/y` PLAN CHECK FEE $