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HomeMy WebLinkAboutF2018-0579 - Permit Application- �1 lication F7_0 for Fire Permit ADP Ion,T Lr Worksheet Worksheet Newport Beach -Buil I how City of rq ;2" � 74 .:Fire Please print 3 copies © Fire Sprinkler ❑ Fire Alarm Misc ❑ suite No Associated Building Permit # Floor � F1 Project Address ( Notmailing address) O # Units 03 _ Tenant Name 2. Description of Work Extg Sq Ft 17777 Total Sq Ft 17777 New/Added Sq Ft /,---_� New Add ❑ Alter ❑ ❑ Demo �— Use q Valuation $ L, # Stories I it Check riate Box for APprrua"•' First ❑ Last 3. Owner's Name `Owner's E-mail Address Owner's Address 77 _ Tel ephone d state ZiP� _ tic.No. city � - First ❑ 4. ArchitectlDesignees Name Last ArchitecUDesigner's E-mail Address 7777777 Architect/Designer6Address i I�� Telephone State !�J Zip City LIC. No. First ❑ 5. Engineer's Name Last Engineer's E-mail Address EnState F_777ip Telephone Engineer's Address Z Class�T City Lic. No. First M,... ❑6. Contractor's Name Last Contractor's Address �\.�1'� �w riVt K• State ty ONLY - GROUP — Contractor's E-mail Address �"sj 76'S��i Zip Telephone _ n PERMIT NO. PLAN CHECK NO. - PLAN CHECK FEE $