HomeMy WebLinkAboutF2018-0667 - Permit Applicationaewvo�
Worksheet for Fire Permit Application
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City of Newport Beach - Building Division 5
Associated Building Permit # F Fire Sprinkler r Fire Alarm [ Fire Misc
1. Project Address (Not mailing address) Floor Suite No
430 F,,jIertPL Ave. P3etc-, CA 92�63 �—
Tenant Name - - _ # Units �-
2. Description of Work
Use
r 0ALV
-
Extg Sq Ft F_ New/Added Sq Ft F Total Sq Ft —.
r New ^ Add r Alter F_ Demo
Check Appropriate Box for Applicant/Notification
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# ries
r 3. Owner's Name Last
First
Owner's Address
Owner's E-mail Address
City
State F— Zip F_ Telephoned
ci 4. Architect/Designer's Name
Last (� First 4 r) l Lic. No.
Architect/Designers Address
Architect/Designer's E-mail Address
City li
�—
_ State } Zip Telephoned—
F_ 5. Engineer's Name Last
First F_ Lic. No. j
i
Engineer's Address
Engineer's E-mail Address
City
State F Zip F ------— Telephone gv' [73
6. Contractor's Name Last
i(Ji"`,�!/� First �— Lic. No. �— Class - (p
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Contractor's Address
Contractor's E-mail Address
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.67.; ffD E
City j / / OD�i( 1—togT j
State �� Zip (,O Telephone l/-h/� g
OFFICE USE ONLY ! I�{�(/
I (/, w— -)l PERMIT NO. � �j 012 7
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v/� PLAN CHECK NO. 60
TYPE OF CONSTRU TION
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OCCUPANCY -GROUP
ANCHECK FEE $
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