HomeMy WebLinkAboutF2020-0426 - Permit ApplicationF��WRrg
Worksheet for Fire Permit Application
City of Newport Beach - Building Divisio 0
Please print 3 copies
rTenant
ted Building Permit #
Fire Sprinkler n Fire Alarm ❑Fire Misc
Floor (Suite a
oject Address (Not mailing address) ; I
v�¢ v Lc�.r�e _ �La.h - k �°�-�—Ace# Units Name
2. Description of Work S Use
• r
i
- - I Valuation $ �18G1�� j
Extg Sq Ft New/Added Sq Ft a I Total Sq Ft (� (�
# Stories rl,
New r
Add [ Alter rl Demo
Check Appropriate. Box for Applicant/Notification
r 3.Owner's Name Last �—_
First F—
Owner's E-mail Address
Owner's Address
City �— I StateZipZip Telephone
4. Architect/Designer's Name Last �V t d0 _ i
First G�Y� Lic. No.
Arnhiteat/Desianeft E-mail Address _-
ArchitecttDesigners Address
City- State
r 6. Engineer's Name Last
Engineer's Address
City State
Zip r_--� Telephone
Zip
First Lic. No. F
Engineer's E-mail Address
Zip ��.._.Telephoner---'L.. . _.
v First ----'i Lic. No. (p� ` Class ( C.1 rb
I •
16. Contractor's Name Last yt lxk^. � —
Contractor's Address
_IDr—S ��C 1— �v - w -A. -:6 aQp
_ __-.-rl L Y \,J State
City
OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY - GROUP
Contractor's E-mail Address
KRA-
Zip 1 _ 3b-7 l,; Telephone; % 3
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEE $