HomeMy WebLinkAboutF2019-0611 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
copies ��Q/(� �'//
GGronM`�
d Building Permit # �- Fire Sprinkler P [I Fire Alarm rf Fire Misc
1. Project Address (Not mailing address)
Floor Suite No
Tenant Name �, /�i
#Units
72.Description of Work
DCL hCi !ten Y1�1 Z rUset r--� New/Added Sq Ft Valuation $ �r �00 F
�I Total Sq Ft
New ( Addr,- Alter r Demo #Stories
Check Appropriate Box for Applicant/Notification - —
j 3. Owner's Name
Last [` i�LL�J� _F1�✓
Owner's Address - -- --" "
City .lV fiWD0 -Fj State
Owner's E-mail Address
Zip��QTelephone,-q-q �'t-of;L�—
[; 4. Arch itect/Designer's Name Last
First—: Lic. No. �-:
Architect/Designer's Address Architect/Designer's E-mail Address
City State F-7-7 Zip�.� 'Telephoned
F-15. Engineer's Name Last
i7Lic. No.
Engineer's Address
Engineers E-mail Address
City
State Zip Telephone
6. Contractor's Name LastFATe First
Contractor's Address
2,7r3 j 0O Contractor's E-mail A4dress
State Zip Telephone
city
/��("�'"�"�\ L. L{
5,) , GZ �p
OFFICE USE ONL y
TYPE OF CONSTRUCTION _
OCCUPANCY - GROUP
PERMIT NO. Vic- I t')
PLAN CHECK NO.
PLAN CHECK FEE $