HomeMy WebLinkAboutF2018-0600 - Permit ApplicationPrint Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
X�1 lAte, ire Sprinkler ❑ Fire Alarm ❑ Fire Misc
1. Project Address (Not mailing address)
Floor Suite No
Owner's Address
Owner's E-mail Address
Tenant Name tZ_e S �
# Units
2. Description of Work
-]First
F7 Lic. No. 77
Architect/Designees Address
Architect/Designer's E-mail Address
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State Zip Telephoned
❑ 5. Engineer's Name Last C j_,4 -'j A 1 First (t/ G S 11-1c. No.
Use
Engineer's E-mail Address
(,.)Z! S_ N-
Valuation $
,
Extg Sq Ft —� New/Added Sq Ft Total Sq Ft
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New ❑Add ❑Alter [7 Demo
Contractor's Address
# Stories
Check Appropriate Box for Applicant/Notification
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3. Owner's Name Last
"Uw ' First �� Q, V1 �
v- t 1
Owner's Address
Owner's E-mail Address
City
State Zip Telephoned
❑ 4. ArchitectlDesigner's Name Last
-]First
F7 Lic. No. 77
Architect/Designees Address
Architect/Designer's E-mail Address
City �_- -
State Zip Telephoned
❑ 5. Engineer's Name Last C j_,4 -'j A 1 First (t/ G S 11-1c. No.
Engineer's Address
Engineer's E-mail Address
(,.)Z! S_ N-
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City Dt2/.�.�l�v� -
State Zip g -797Z
7TTelephone
F-]6. Contractor's Name Last 1� r-_ L p First ; ; J Lic. No. ClassM;7
Contractor's Address
Contractor's E-mail Address
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SZ (V_ 141_5u-? lyre �✓1o%G c /. c �. —
City
State Zip C�a �6` Telephone ?/11_7*:1:T-77:3 ,
OFFICE USE ONLY
PERMIT NO. 5 U0 - NO DU
TYPE OF CONSTRUCTION—
PLAN CHECK NO. 900- ZVI'S
OCCUPANCY- GROUP
¢
Vh 67)01�P[AN CHECK FEE $