HomeMy WebLinkAboutF2019-0224 - Permit Application (2)Print Form Worksheet for Fire Permit Application r Hr
City of I)IRwport Beach - Building Divisio
Please print 3 copies
Associated Building Permit #
J e ire Sprinkler j-' ire Alarm r Fire Misc
I. Vrolect Address (Not mailing
Tenant Name
2. Description of Work
by c� 11Kq F,r S NRin h tti� S� t f
Extg Sq Ft r- --' New/Added Sq Ft �I Total Sq Ft
G New F_ Add r Alter [- Demo
Check Appropriate Box for Applicant/Notification
f 3. Owner's Name Last
First F_.._-_,._._-_,_
-
Owner's Address
Owner's E-mail Address
-461 FloorSuite No
�J v ) F_7
# Units FI
Use
Valuation $
�oOcJ j
# Stories L
City r _ State _-_- - - --
- ___ -- -- - - I Zip �-: Telephone.—_.._
i 4. Arcmtect/Designer's Name Last
First r-___—_ Lic. No. F
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
City�� State
ZAP F— Telephoner�
5. Engineer's Name Last
First Lic. No.
En
gineer's Address
City
-- _- -- -_ -- State F ------�
V 6. Contractor's Name Last F yD 4 t c
Contractor's Address
Iz3 t` LE14T12A,,t. A-vr-
tY yl
Ci { °N 12v V /r i State F _.
OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY - GROUP
Engineer's E-mail Address
Zip �� TelephoneF— —'
First t 554 t 6- Lic. No. 7
Txl Class
Contractor's E-mail Address
Zip \ 0IG Telephone 62te� S Li0,y S -
PERMIT NO. ( ' 4
PLAN CHECK NO. ODD
PLAN CHECK FEE $