HomeMy WebLinkAboutF2011-0203 - Permit ApplicationAt
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OgaF-2011
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Workshe t for Fire Permit Adplication
City of Newport Beach - Building Department
Fire Sprinkler
fl Fire Alarm
j'e Misc
1. Project (Not mailing address) Suite No
IFloor
,Address
t
Om \Do.
DINR/
\
I
I _
Tenant Name (if Applicable)
II }}
r� Q0.1 vit0r\d.1 1'loJ? )0.\
# of Units (if Residential) iii
2. Description of Work
PCA)..,
Uselci/
r
Gr.,
`` 11
&o.a O4kc)Zoi\ St) rkw\ eikyvvA4
If Sprinkler How Many Heads?'
7
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1 I .I� H
Valuation •
,o oo °
I SQ --
# Stories
13
Check Appropriate Box for Applicant/Notification Information
(-/3. Owner's Name Last
Owner's Address
I t j4 k\Doy\
Owner's
First I
E
f- 0,1
mail Address
(� n1 1
evJpor"I
OBI R- \ ts'I
&coc� I
[New
port
a1�oR.....r_NI
U+o cin
State I
C �
Zip
L 5"?.., 6;
5
Telephoner626)
7S`f -9 r 38
�Ciit�y
f;'4.
Architect/Designer's
rchitect/Designer's Name Last
Address
I Co\.r
Architect/Designer's
First
I I i0c'
E-mail
Address
Lic.
No.
IIIrW
C6-liforn;a
1
Oka), PM8
Z
Zo;-
(0MPro1ec4eeSMasSoc.con,
City
I Po,),„0/4,„
State
I CA
Zip
19 1 105
TelephonelC6%)
L%9_ 1 / 96
r(5.
Engineer's
Engineer's Name Last
Address
j N O
K O I D
Engineer's
First
l 'roln
E-mail Address
Lic.
No.I
C 20321
I03
Lk) Ct..Ii for„:c. J &vd, OAP204-
(e)t1" r0.3eG{,
e_0
Ivi Qj5OC. Co vn
City
I.P4^)/"den.-
State
I CA
Zip
911 OS
Telephone'
[Z6. Contractor's Name Last
Contractor's Address Ott ai
tee, First'
ur?� 04. 2 -3 , i Z. Contractor's
til It
E-mail Address
Lic. No. I
/33fi8$
class'
*'I
30
is,
if 5
'Z0o62.- Ai/Cl, SJ Sui4 300
I aiixlPilve)->I-ycaadrocd;on... con
City
IN/w/o/4 teach State
I cA
PAJ 2660
Telephone'
(9gq) 250-0060
PERMIT NO. ZOII -t� aO3
OFFICE US ONLY MAY73
2011
/ I IZ CHECK NO i 5
Rev 1/18/0 `PLAN
Associated Building Permit #
I CITY OF NEWPORT BEACH'; PLAN CHECK FEE $
3 ,