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F2019-0411 - Permit Application
Please print 3 copies Associated Building Permit # ' Worksheet for Fire Permit Application 0"I I I City of Newport Beach - Building Division j Fire Sprinkler F_j Fire Alarm ( Fire Misc 1. Project Address (Not mailing address) Floor Suite No Last 61_ j -P/Tt/,X" o First--', I. Tenant Name... tea, © ii Units F JI P 2. Description of Work Owner's E-mail Address Extg Sq Ft F —I New/Added Sq Ft �� Total Sq Ft �, Valuation $ (I F, New r: Add F7 Alter F7 Demo # StoriesI (� Check Appropriate Box for Applicant/Notif!cation Infn�m Minn (!, 3. Owner's Name Last 61_ j -P/Tt/,X" o First--', I. Owner's Address Owner's E-mail Address City StateFW Zip Telephoned M1� (— 4. Architect/Designer's Name Last. Lic. No r— Architect/Designer's Address Architect/Designer's E-mail Address city State F_,Zip F....._ -_i Telephone....... F-; 5. Engineer's Name LastFirst— Lic No.Z���'. Engineers Address Engineer's E-mail Address City _. r_ State Zip II .._.. -.. Telephone F 6. Contractor's Name Last A-4 0,10 �� ` First r _--; Lic. No. F��1: q13CIassF ho Contractor's Address Contractor's E-mail Address oCce�w D\jttji t5�V,,t�r i City T iVy - �culyv_ - _ - State Zip " L `7'I Telephone) OFFICE USE ONLY / aG�/ PERMIT NO, TYPE OF CONSTRUCTION / OCCUPANCY -GROUP �� it y PLAN CHECK NO, - PLAN CHECK FEE $