HomeMy WebLinkAboutF2020-0498 - Permit ApplicationWorksheet for fire Permit Application
City of Newport Beach - Building Division X70/10 , 04 9g
Please print 3 copies
Associated Building Permit # �!— P. Fire Sprinkler rl Fire Alarm (71 Fire Misc
1. Project Address (Not mailing address) Floor Suite No
Tenant Name1 O �-� �- �, - # Units
2. Description of Work
Use
F
I
_. __ 1
Extg Sq Ft New/Added Sq Ft j -i Total Sq Ft p
Valuation $
New Add Alter r Demo
# Stories
�r
� ' 7. - --'
Check Appropriate Box for ApplicantlNotification
[i 3. Owner's Name LastFirst � /�,,, � 1�I ._
_ C"X`1'pjl� lam✓' �/
Owner's Address Owner's E-mail Address
i
City 15Kate Zip Telephone
r 4. ArchitectlDesignees Name Last 1 i First ,' Lic. No.
Architect/Designees Address Architect/Designers E-mail Address
City State r Zip F- __7l Telephone
F7 5. Engineer's Name Last First Lic. No.
Engineers Address Engineer's E-mail Address -
City �— .-- , _ -- State �., Zip — Telephone
rib. Contractor's Name Last /� j I First C7A��' Lic. No. ' �� Class,
Contractor's Address
Contractors E-mail Address
city[
[ Lam/ cEie2_ ate Zip � (��� Telephone
1lld u,/
City ��-- ',�'T - State � 7
004
OFFICE USE ONLY ?'yr=,y . PERMIT NO. _ &�q� , lb
TYPE OF CONSTRUCTION Y �Is PLAN CHECK &Wy NO. MLAr"
OCCUPANCY -GROUP 0� , PLAN CHECK FEE $