HomeMy WebLinkAboutF2019-0338 - Permit ApplicationWorksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies F2 -01c(. ,2020
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Associated Building Permit # I j K Fire Sprinkler (-1 Fire Alarm 171, Fire
1. Project Address (Not mailing address)
Floor Suite No
19gZ?
Owner's E-mail Address
City �— State F Zip F—'', Telephone—
[ 4. Arch itecUDesigner's Name LastG' ,First ial o Lic. No.(---
Tenant Name I
_.. _.. _._ __.j
# Units
I
2. Description
of Work
State c Zip R17V. � TelephoneW�� ( �l /4_00 y..._ ._..
F-- 5. Engineer's Name
Last �— First I"---'. Lic No.l —
III
Engineer's Address
Engineer's E-mail Address
Usei
State .. Zip F_, Telephone
Extg Sq Ft
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New/Added Sq Ft ri Total Sq Ft ��i
Valuation O(j�?
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F New
[—•••••. Add
r Alter F_ Demo
j
# Stories F2_
Check Appropriate Box for Applicant/Notification
F7; 3. Owner's Name
Last �wii� �AlrstF
Owner's Address
Owner's E-mail Address
City �— State F Zip F—'', Telephone—
[ 4. Arch itecUDesigner's Name LastG' ,First ial o Lic. No.(---
Architect/Designer's Address
Architect/Designer's E-mail Address
City We 54 ( . v, vt4
State c Zip R17V. � TelephoneW�� ( �l /4_00 y..._ ._..
F-- 5. Engineer's Name
Last �— First I"---'. Lic No.l —
III
Engineer's Address
Engineer's E-mail Address
City .._
State .. Zip F_, Telephone
r 6. Contractor's Name
Last riY iy1,VaYG� Prly k�e r, First_ ', Lic. No. II ftdZ Class �6
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Contractor's Address Contractor's E-mail Address
95Y� _V lda•rr" AYRa-9N�r'! ooni
City ,Sd J� .-c/..�R ----..
State CI 4 Zip�Telephone .O�QC/07)J/%1 ('�
OFFICE USE ONLY
TM��1. Qj PERMIT NO. U q - Obb"O
TYPE OF CONSTRUCTION
X/WtI .0(A;- PLAN CHECK NO.
OCCUPANCY- GROUP
PLAN CHECK FEE $