HomeMy WebLinkAboutX2019-1171 - Permit Applicationgl6g 8019
r�`a0l J• GL1%tl Worksheet for Fire Permit App iicati n o.
City of Newport Beach - Building Divisi n
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Associated Building Permit # � ( � Fire Sprinkler (—i Fire Alarm rl Fire Misc CS }ham S
1. Project Address (Not mailing address) Floor Suite No
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Tenant Name j�j,�V I #Units
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2. Description of Work
Owner's E-mail Address
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Use
Extg Sq Ft �- New/Added Sq Ft 1 -Total Sq Ft
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Valuation
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# Stories
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Check Appropriate Box for Applicant/Notification
F7 3. Owner's Name Last
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Owner's Address
Owner's E-mail Address
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State
Zip F Telephone(--
4. Architect/Designer's Name
Last
First r— Lic. No.l
Architect/Designer's Address
Architect/Designer's E-mail Address
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Zip �, Telephone
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F- 5. Engineer's Name Last/'��
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First �/� Lic. No.
Engineer's Address
Engineer's E-mail Address
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Telephone
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6. Contractor's Name Last
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First will Lic. No. $7 �3 Class
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Contractor's Address
Contractor's E-mail Address
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OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
�� a �3� PLAN CHECK NO. LOWV9
OCCUPANCY- GROUP
PLAN CHECK FEE $