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F2019-0419 - Permit Application
Worksheet for Fire Permit Application City of Newport Beach - Building Division 16'1//13-aOlq Please print 3 copies FZ01 o f/ Associated Building Permit # j Fire Sprinkler �I Fire Alarm 7 p _. j -i Fire Misc 1. Project Address (Not mailing address) Floor Suite No Z� 2- co/,�57-_1f16#uJ5lrl S-() (Co_ 1-3" X50_ Tenant Name FC_o A -5V- (Ljorj 11SS CGS 3 q #Units F 2. Description of Work Owner's E-mail Address -- Use l� F�rCC i State �—� AW-5 Etre 7JL'iN /I _ KC�� I�c�fi%S �J� 4ai:ZJJiTLC- 1- 4. Architect/Designer's Name Extg Sq Ft F --I New/Added Sq Ft F Total Sq Ft Valuation $ --1 r New Add Alter I^ r Demo #Stories Check Appropriate Box for Applicant/Notification 1959W j- 3. Owner's Name Last �— First F', Owner's Address Owner's E-mail Address -- Crty �- i State �—� Zip F Telephone[------ 1- 4. Architect/Designer's Name Last FirstF - Lic. No, Architect/Designer's Address Architect/Designer's E-mail Address City �— -. State--; Zip F i TelephoneF� F7 5. Engineer's Name Last -- First —' Lic. No, F Engineer's Address Engineer's E-mail Address City State-- Zip F-- Telephone !"76. Contractor's Name Lastv- 2- First ©pJ Lic No. �Z9 � Class C Contractor's Address Contractor's E-mail Address City TL C_&JT IA -_.-.. State Cf7 Zip 9Zg7o ! Telephor{e"'7/t(: 9,O =- /�` // OFFICE USE ONLY PERMIT NO. TYPE OF CONSTRUCTION _ n J ' jI�U( vhl PLAN CHECK NOA (04PaP1I OCCUPANCY- GROUP PLAN CHECK FEE $