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HomeMy WebLinkAboutF2018-0416 - Permit ApplicationWorksheet for Fire Permit Application o p4 `W @ City of Newport Beach - Building Division /76l-z0ro o Please print 3 copies VW 19 _ 0y/6 G.�oaH�> Associated Building Permit # Fire Sprinkler [ Fire Alarm C Fire Misc 1. Project Address (Not mailing address) Floor Suite No Tenant Name. # Units1 II 2. Description of Work Use NL'U-) -1—�i�-`�/tuf-�2✓ _4V� ��.(..9.% S��f„,�T�v-l���y1�2 Extg Sq Ft �' New/Added Sq Ft �'� 6 ! Total Sq Ft ( �.. Valuation$ 1 50©, ,5 - Zirj"d _ Telephone #Stories III New �� Add F__ Alter F_ Demo Architect/Designer's Address Check Appropriate Box for Applicant/Notification [—'3. Owner's Name Last L V t J First ki Owner's Address Owner's E-mail Address - City -.. �`'�. State Zirj"d _ Telephone F_ 4. Architect/Designer's Name Last First F Lic. No.F Architect/Designer's Address Architect/Designees E-mail Address City � --_ State F7_ Zip F Telephonel-- (7 5. Engineer's Name Last FirstF Lic. No. Engineer's Address Engineer's E-mail Address City State F_ Zip Telephone— j6. Contractor's Name Lash „v� First i (�' Lic. No. 5�� 1(Jj Class C i6 \ Contractor's Address Contractor's E-mail Address -� ��J;4ce %ue Slt�l-e 7kS__r.-tou-tc .StateI ,`6[ City I Iv .r��a,��-, e,0.C�t ` Zip Z6(D Telephone! 7N T 1`f Z540 OFFICE USE ONLY PERMIT NO. FSV is • 0 -*ll' TYPE OF CONSTRUCTION PLAN CHECK NO. lkl 2719 OCCUPANCY - GROUP PLAN CHECK FEE $