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F2019-0232 - Permit Application
Worksheet for Fire Permit Application of VMe Print Form: �Z7City of Newport Beach - Building Division u g Please print 3 copies Associated Building Permit#�( _,A/D� Fire Sprinkler 13Z-FireAlarm FFire Misc 1. Project Address (Not mailing address) Floor Suite No I Bol3qYSr)DE- 7R.tVE_ F�� Tenant Name '4LI30y-- IV/�,rj,. V AF C_L�� # Units 1 lBld � 2. Description of Work City 2EPPW`z`-F OLD FI2C F�I�GZ �lH�p 17i��CCs Use z— S Valuatio4Z Extg Sq Ft New/Added Sq Ft Total Sq Ft �', f©f rA-rrc-h-iitteecctt/Designer's State �' Z}o I Telephone�� # Stories I- New F_ Add F_ Alter F- Demo U —I& _Sv Te Check Appropriate Box for Applicant/Notification F_ 3. Owner's Name Last First F— Owner's Address Owner's E-mail Address City State F_ Zip r- Telephonel�' F_ 4. Architect/Designer's Name Last First F— Lic. No. F Architect/Designer's Address E-mail Address City rA-rrc-h-iitteecctt/Designer's State �' Z}o I Telephone�� F_ 5. Engineer's Name Last,tel 'First r_ Lic. No. Engineer's Address Engineer's E-mail Address city State F Z Telephone ,Z6. Contractor's Name Last -Pc-' ON First &TZA K_ Lic. No. Class C^ C Contractor's Address Contractor's E-mail Address 15131 �1t>U� IE III 0-2-1 14 (�D /tiI/Q7t So C/A-, CO -LI City hll�r i�t�r5�vr� 3 c�1 State CL}- Zip R� cj,c( Telephone I?/y 5 1R-(:-) r s1 o OFFICE USE ONLY OF CONSTRUCTION PERMIT NO. 1;F 'ZO \e'`t a O Z -s `� ` d 0?5 Z6- ?�OM TYPE PLAN CHECK NO. OCCUPANCY- GROUP PLAN CHECK FEE $