HomeMy WebLinkAboutF2020-0307 - Permit ApplicationWorksheet for Fire Permit ApplicationU�cw
Print,Forhty;. City of Newport Beach -Building Division
Please print 3 copies Lo LO - b 1j 0 a
Associated Building Permit #I Fire Sprinkler r Fire Alarm r Fire Misc
7. Project Address (Not mailing addres At Floor Suite No
l2 Std f s - - ► l f F -- — -- _ F77
Tenant Name # Units �I
2. Description of Work
Use
1
Extg Sq Ft New/Added Sq Ft F—', Total Sq Ft �—
Valuation $
r. New r Add F- Alter r Demo
# Stories
LonecK Appropriate Box for Applicant/Notification
Ingormatmon
r 3. Owner's Name Last 4 2JAu � Owl irs cviD i�
Owner's Address ne s E-mail Address
City fV `J State �— Zip Telephone
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4. Architect/Designer's Name Last -
AFirst \ �j Lic. No.
Architect/Designer's Address gct/Designer's E-mail Address
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City U✓1 Ll✓1 ((l - State CA-� Zip t?�-�
! =? -7S Telephone Telephone li ! • �j t 7 .
r 6. Engineer's Name Last First Lic. No.
Engineer's Address Engineer's E-mail Address
City State F7—! Zip I—
Telephone�—
S. Contractor's Name Last ! n i' A�t f First f� Lic. No. Class
Contractor's
Contractor's Address lJ� l/Contractor's E-mail Address 4 Gv- LIy {) 3
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City SG -/lyi ( State --- Zip tie (US Telephone 7t t--/
OFFICE USE ONLY -C):?62C.) v PERMIT NO.
TYPE OF CONSTRUCTION \ `Z6) fl a�(s , PLAN CHECK NO
OCCUPANCY -GROUP iC t!IL l�( •�) PLAN CHECK FEE $
CITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
PLAN SUBMITTAL FORM
Print Name:
Signature:
❑ Pick-up Plans
Date: U I v
Permit Tech:
Phone#: qL)q_'33[_' sgols
Email: )6P,_2G('�IV1-C4D b-eog2
a0d PJJOC I Q - CV S
Plan Check/Revision #: Project Address Additional Information
gSubmitting Plans
Plan Check or Revision Number
Number of Plan
Sets or
documents
Name each document i.e., permit
application, plans, structural calcs, soil
report, etc.
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Payment Method
Payment can be made by credit card via phone at (949) 718-1888.
PAYMENTS MUST BE MADE AFTER 48 HOURS OF SUBMITTAL DUE TO QUARANTINE OF PLANS
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