HomeMy WebLinkAboutF2020-0220 - Permit Application (3)Worksheet for Fire Permit Application
City of Newport Beach - Building Division
Please print 3 copies D4t
Associated Building Perm re Sprinkler r Fire Alarm r Fire Misc
1. Project Address (Not mailing address) r4o Suite No
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b � IV/ H S7�et� % r-FuC%i'o jv _ I : _E F
Ma
/se # Units
Tenant Name c
G�Z _ ON
2. Description of Work q y
Use
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R _-Stytl/ c (SO.vwv7� j — " uG
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EMg Sq Ft New/Added Sq Ft l 1Total Sq Ft
Valuation $ Z� oay j
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rj( New (' Add F_ Alter 7 Demo
It Stories �I
Check Appropriate Box for Applicant/Notification
F_ 3. Owner's Name Last
First CFP&4-
Owner's Address
Owner's E-mail Address
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_ oe_e L.Kq �a 4lisr-"' `•_ (/L.�. _ _ -
City jl%:%�aw- State F'.
Zip / zic-5 Telephone(------
i- 4. Architect/Designer's Name Last
First F Lic No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City State
Zip Telephone)
i—' 5. Engineer's Name Last
First Lic. No.
Engineers Address
Engineer's E-mail Address
City F— State F--
Zip F Telephone— i
6. Contractor's Name Last Gf �1 Cl "j
Firs/� Lic. No�Class �` C/ t
Contractor's Address J
Contractor's E-mail Address
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City �aa • - State F64�—.
Zip 1 ?2e-Z Telephon
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $