HomeMy WebLinkAboutF2019-0009 - Permit Application1C� - go C)9 Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies
Associated Building Permit# Fire Sprinkler I_._ Fire Alarm
1. Project Address I
MA -1 I
Tenant Name liewpogg
2. Description of Work
Extg Sq Ft �— New/Added Sq Ft !ej bOD.-_-- Total Sq Ft
New r Add F- Alter F7 Demo
Check Appropriate Box for Applicant/Notification
F- Fire Misc
Floor Suite No
7�:_ 7—
# Units
Use
L
Valuation$,
V r.
# Stories 2
J- 3: Owner's Name Last �. / + Firsts
Owner's Address Owners E-mail Address
City T L), ,at_...-�e4 /, _-, State �Zip �— Telephoned—
ner's Name Last ( ..L�, First Lic. No.
F- 4. Architect/Desi
g �✓- CrhT�ezl7--_-
Architect/Designers Address ArchitecVDesigners E-mail Address
I
Ron Shafer l Superintendent Zip 4/ 730 _ Telephoned y )q. ,, 'j. o fl)
n4nai
T 714.641.2390 First�-�/—%-'�/� Lic. No.
F 714.380.9411 _ i
nn 714.380.4103
_ Engineers E-mail"Address _
TELACU Construction Management
604 N Eckhoff Street �7-
,- . Orange • CA 92868 Zip Telephone
TELACU w .TELAGU.cam rshafer@TELACU.com AV
1. 6. Contractor's Name LastL��� ��GptS�i l�tJd�
Contractor's Address �c '! I- /y�
T „' - Ee p f• & S rz GAG
City �>: 12-A State
First. _ Lic. No. � Classi
Contractors -E-mail Address
. _.
Zip g � Telephonel -71 "✓ f I -,23W
OFF/CE USE ONLY lye (�Q " 0�- T PERMIT NO. I n -012LJ l�
TYPE OF CONSTRUCTION PLAN CHECK NO.GM�j Y r
OCCUPANCY - GROUP CJ"L C. PLAN CHECK FEE $