HomeMy WebLinkAboutF2018-0513 - Permit ApplicationWorksheet for Fire Permit Application "red
City of Newport Beach - Building Division
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Associated Building Permit # 141 w5 ire Sprinkler r-1 Fire Alarm [-j Fire Misc
11.. Project Address (Not mailing address) q Floor Suite No
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Tenant Name �i��Q �v1, 1 �' # Units
2. Description of Work
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' Extg Sq Ft F New/Added Sq Ft - Total Sq Ft `r i oq
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Valuation $ .L
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,j7` New [` Add �', Alter r Demo
# Stories
Check Appropriate Box for ApplicantlNotification
( 3. Owner's Name Last r—® First
Owner's Address Owner's E-mail Address
Zi Telephone
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4. Architect/Designer's Name Last 'A First p p cu; Lic. No. —
Architect/Designer's Address,( Architect/Designer's E-mail Address
City 2� �r_�� �� State �� Zip Telephone�^�t_2F�1-S$ I$
h 5. Engineer's Name Last— First r� Lic. No.
Engineer's Address Engineer's E-mail Address
City ��-�- State Zip - Telephone
(7 6. Contractor's Name Last ��� pnFirst Lic. No.� S o3i Class
Contractor's Address Contractor's E-mail Address
City ., V£�'US State � avvZip Telephone
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OPF'ICE USE ONLY PERMIT NO.
TYPE OF CONSTRUCTION PLAN CHECK NO.
''raOCCUPANCY
- GROUP PLAN CHECK FEE $